Chest pain can either represent a mild condition or a potentially life-threatening situation. It can be challenging to differentiate potential causes in an outdoor setting. Awareness, early recognition, and prompt evacuation are key to minimizing the chances of a bad outcome.
Symptoms and Description
Heart and lung issues can present as pain or pressure in the chest along with a variety of related symptoms.
Symptoms
- Pain (may radiate to the neck, left arm, or back)
- Chest pressure
- Shortness of breath
- Overwhelming fatigue
- Dizziness
- Sweaty and clammy skin
Are you or a companion experiencing chest pain?
If yes, launch medical assessment below.
Defining Your Risk Category
It is important to understand your individual risk factors and past medical history regarding chest, heart, and lung issues. More strenuous outdoor activities can stress the heart and make underlying conditions worse, even if they were previously stable.
Those at higher risk levels should obtain medical clearance from their doctor prior to beginning new outdoor activities. Consider the following to define your risk category and plan accordingly.
Lower risk
- Age less than 45
- No family history of early heart attacks
- No more than 1 high risk medical problem
Higher risk
- Age greater than 45
- People who have 2 or more of the following high risk medical problems: diabetes, high cholesterol, heart disease, or high blood pressure
- People with history of heart attacks, heart failure, or history of heart surgery
Guidelines for Safe Travel
Assessment
- Those with higher risk factors should get clearance from a cardiologist and/or consider a stress test prior to undertaking physically demanding or strenuous activities.
- Understand the individual medical risk factors of people in your group.
Preparation Medications
- Carry your prescription medications when traveling outdoors.
- PACKING LIST: prescription medications, ibuprofen or acetaminophen, chewable aspirin.
Heart Attack
A heart attack may present as a varied range of symptoms which could include:
- Chest pain or pressure, sometimes radiating to the neck, left arm, or back
- Shortness of breath
- Overwhelming fatigue or dizziness
- Sweaty and clammy skin
These symptoms are usually exacerbated by exertion and are due to an inadequate blood supply to the heart from an obstructed or narrowed blood vessel. They may be an early warning sign of an impending heart attack.
Keep in mind that severe, constant symptoms may represent complete obstruction of a blood vessel which requires rapid evacuation to a hospital for definitive treatment.
Treatment Options
- Have the person rest to minimize stress on the heart. Further exertion may worsen the condition.
- If medical care is unavailable, it may be necessary to have them walk to assist in evacuation. Proceed with care.
- If the person has persistent chest pain, bring medical care to your location if possible.
- If available, and not allergic, take 325mg of aspirin (or four 81mg tablets).
Are you or a companion experiencing any symptoms consistent with a heart attack?
If yes, launch medical assessment below.
Chest Wall Pain
Chest pain can be caused by a mild inflammation of the lining of the ribs or a muscle strain. The pain may be sharp or dull and is often reproducible when pushing on the chest wall.
This condition is not typically of immediate concern.
Treatment Options
- Taking Ibuprofen or acetaminophen will often take care of these pains.
- Monitor for worsening of symptoms.
Blood Clots
Chest pain can be a serious (and potentially fatal) problem in the lungs like a blood clot (known as a pulmonary embolism).
- Blood clots may present gradually or suddenly. They can be sharp or dull, and are often worse when taking deep breaths.
- There may be associated shortness of breath (with or without pain). It is often exacerbated by exertion.
- Chest pain with shortness of breath, especially in those with higher risk for blood clots, is considered a medical problem.
Higher risk
- Women who are pregnant or taking estrogen-containing birth control
- Tobacco smoking
- Person with a history of blood clots
- Person undergoing treatment for cancer
*Recent surgery
Treatment Options
- If medical care is unavailable, it may be necessary to have them walk to assist in evacuation. Proceed with care.
- If the person has persistent chest pain or cannot exert themselves to get help, bring medical care to your location if possible.
Are you or a companion experiencing any symptoms consistent with blood clots?
If yes, launch medical assessment below.
Palpitations
The presence of a loud, fast, or irregular heartbeat is called palpitations. Symptoms may include:
- skipping beats
- chest tightness
- lightheadedness or weakness.
The type of heart rhythm can range from mild and annoying, to debilitating, or even life threatening. Let the duration of the palpitations and severity of symptoms be your guide to the severity of the problem. Those who are at high risk for a heart attack may have more dangerous heart rhythms causing palpitations then those who are young and healthy.
Treatment Options:
- Take a deep breath. Pinch your nose shut. Close your mouth and blow out hard for 10 seconds.
- Take a deep breath and plunge your face into cold water.
- If unable to slow down a persistent fast heart rate, consider evacuation.
Are you or a companion experiencing heart palpitations?
If yes, launch medical assessment below.
Emergency Red Flags
Keep an eye out for the following symptoms. These red flags may be cause for evacuation.
- Persistent severe chest pain/pressure often worsened on exertion.
(See heart attack)
- Sharp chest pain, often worsened on deep breaths, with shortness of breath
(See blood clots)
- Sustained elevated or irregular heart rate
(See palpitations)
If yes, launch medical assessment below.
Are you concerned about chest pain?
Download GOES to launch a digital medical assessment or speak with a wilderness medicine physician.