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Randall Howell, DO

Dr, Howell and 11 other Washington University specialists in emergency medicine treat patients:

Emergency Room
Barnes-Jewish West County Hospital
12634 Olive Blvd., Creve Coeur, MO 63141
Phone: 314-996-8472

Question: My 57-year-old husband had a pain in his chest last week. It went away after 10 minutes, so he didn’t go to the emergency room. Should all chest pain be evaluated in the ER?

Answer: Chest pain can be a difficult symptom for a non-medical person to assess. If you or someone you’re with develop chest pain, the first thing to consider is the nature of the pain and secondly, what other symptoms might co-exist.

Is the pain pressure-like or burning? Does he or she have shortness of breath, nausea and/or sweating? These characteristics suggest a high-risk situation.

Other medical risk factors make the pain more likely to be caused by the heart – such as high blood pressure and/or diabetes. Does the person have a history of coronary artery disease (an already identified disease of the heart)? If any of these are true - Call 911. Do not hesitate in making arrangements for this person’s travel to the hospital. Time is of the essence when the symptom of chest pain presents itself in this situation. If the patient does not have any contraindications (allergies) to aspirin, administer 3 baby aspirins (81 mg), if available, as soon as possible.

There are times when chest pain is less likely to be dangerous, such as pain that is very brief, sharp, or related to movement of the trunk or arm. These may be due to gastric reflux or muscle strain or injury. But even if the pain seems less likely to be serious, Emergency Physicians will gladly evaluate the symptoms.

If you transport the patient to the ER, choose the closest appropriate facility to your location. Attempt to bring a list of medications and medical records with the patient, but do not delay going to the ER if you are unable to find the records. Stay calm, since your own anxiety may only worsen the patient’s symptoms. Keep the patient at rest until the ambulance arrives.

Prepare yourself to assist with emergencies. Learning Basic Life Support (BLS) is an excellent place to start. Learn to use an Automated External Defibrillator (AED). These techniques have been shown to save lives

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