Duration Health

When could chest pain be a heart attack?

You are trekking up a mountain when you suddenly have pressure in the center of your chest, with accompanying shortness of breath and sweating. You have no pain in your arm or jaw. What is the next best step?
(A) Wait 30 minutes and reassess your pain
(B) Take ibuprofen

The patient described in the question is having a heart attack ("myocardial infarction").

Chest pain is a medical emergency and it is often difficult to distinguish between benign causes of chest pain, such as a muscle strain, and more severe causes, such as a heart attack. Deadly causes of chest pain include myocardial infarction (heart attack), pulmonary embolism (blood clot in the lung), pneumothorax (collapsed lung), cardiac tamponade (fluid around the heart), aortic dissection (tear in the large blood vessel in the chest), and more.

Whenever in doubt, it is best to treat chest pain as a medical emergency. Consider taking aspirin by mouth (325 mg) and seek immediate medical attention. Aspirin has been shown to improve outcomes in patients having a heart attack.

Why are the other answers incorrect?

A) Wait 30 minutes and reassess your pain
If a heart attack or other emergency is occurring, time is of the essence. Waiting could make the problem worse.

B) Take ibuprofen
Ibuprofen is an appropriate treatment for minor musculoskeletal pains. However, the pain described in the question is concerning for an emergency cause.

C) Disregard the pain, as it is unlikely from a serious cause
The pain described in the question has features that suggest a cardiac cause. Chest pain with the following factors is more likely to be caused by a heart attack:

  • Patient over 45 years old
  • History of heart or lung problems (prior heart attack, stroke, cardiac stents)
  • Chest pain that worsens with exertion
  • Chest pain that radiates to the shoulders, jaw or arm
  • Shortness of breath
  • Sweating
  • Nausea or vomiting
  • Chest pain after trauma or injury

However, even if all of these factors are absent, chest pain can still be due to a heart attack or other serious cause! For example, in the question above, the patient did not have radiation of the pain to the arm or jaw, but was still having a heart attack. It is a common misconception that these features can rule-in or rule-out a serious cause of chest pain.

For this reason, chest pain should be considered a medical emergency.

Duration Health prescribes and ships the medications you're most likely to need when regular medical care is unavailable

Med Kits include unlimited access to a physician for 1 year

Only your Duration Health provider can decide, based on your medical history and other factors, whether it is medically appropriate for you to receive prescriptions.


Learn What To Do In a Medical Emergency

Get our free email series, Where There is No Doctor. We’ll teach you how to treat the most common medical issues, anywhere.

Serving travelers since 2019 and shelterers-in-place since 2020

[email protected]
Two Embarcadero Center | 8th Floor
San Francisco, CA 94111
(855) 340-8969

Privacy Policy
Notice of Privacy Practices
Terms and Conditions

© 2021 Duration Health
We're hiring!

Only your Duration Health provider can decide, based on your medical history and other factors, whether it is medically appropriate for you to receive prescriptions. We do not sell prefabricated bags of pharmaceuticals. Each Duration Health Med Kit that contains prescription medications is custom assembled, tailored to each individual patient's needs.

Duration Health is not a pharmacy, is not a nonprescription retailer, and does not sell medications directly. To be able to deliver a customized kit of medications, Duration Health has partnered with a third-party mail order pharmacy. You may request that any prescriptions be sent to an alternate pharmacy. Duration Health charges an administrative convenience fee for its services, but Duration Health does not sell prescription or over-the-counter ("OTC") drugs, mark-up the cost of prescription or OTC drugs, or retain any portion of the fees our affiliated pharmacy charges to you. Nor does Duration Health provide medical advice about or prescribe OTC medications. In states where Duration Health’s physician consultation services are not offered, Duration Health only offers OTC products and does not provide clients with access to obtain a physician consultation. Clients are free to purchase OTC medications of their choice as an OTC-only kit.

You must complete the included online telehealth visit, including a complete medical history and ID verification, before any prescriptions are issued. You may not be eligible to receive items pictured or described on this site. Furthermore, renewal of your prescriptions is contingent upon continued medical appropriateness. Generics only. Brand names are listed on our site for your reference, but in most cases, only generic (non-brand) medications are included in our Med Kits. No controlled substances. Our formulary excludes controlled substances like opioids, benzodiazepines, and other potentially addictive medications. Treatment not guaranteed. No medication is guaranteed to work or guaranteed to treat a particular condition or disease. Use medications only as directed by a physician. Medication uses listed on this site are for educational purposes only and are not intended to represent indications for treatment. Email support only. Our providers are available via email to answer questions about your Med Kit. For non-emergency use only. In an emergency, call 911 or seek local emergency care. No routine care. Duration Health email support cannot be used for routine primary care. Medications prescribed by Duration Health cannot be used for routine purposes. This product is intended only for people who are unable to obtain regular medical care. You must anticipate living, working or traveling where care is unavailable. As a condition of purchase, you must consent to use of these medications only when regular access to medical care is unavailable. Your eligibility for Health Savings Account (HSA) or Flexible Spending Account (FSA) payment and reimbursement is not guaranteed; consult with your health plan, a qualified accountant, or a tax professional to determine your eligibility for reimbursement. Duration Health does not provide or claim to provide any medication or other item to prevent, treat or cure COVID-19.

The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

See our Frequently Asked Questions (FAQ), Privacy Policy, Notice of Privacy Practices and Terms and Conditions for more important disclaimers.