– Chest pain is something that we define as patients coming to the emergency department describing any symptoms between their face to their mid-abdomen. So, any discomfort in that area is described as as chest pain. Patients should take chest pain very seriously because the number one cause of death in the United States for both men and women is heart attacks and the number one symptom that they have with heart attacks is chest pain and very often people think that heart attack chest pain is a severe pain that is the worst pain in their lives. Any chest pain could be a heart attack and so patients can have subtle discomfort or squeezing pain that they’re not defining as pain that could be a heart attack. Then we ask them to call 911 and come immediately to the emergency department so that we can figure out if it’s a heart attack or not because heart attacks kill patients. People describe chest pain in many different ways. Some describe it as tightening, some describe it as sharp, some describe it as burning. It may increase with certain things like breathing, it may reduce with certain things like position. So, there are a variety of chest pains, each point to different causes of chest pain. The symptoms of chest pain for something like heart attack can actually be very different between men and women. Women tend to describe more of chest discomfort. If you ask them if you have chest pain, they say no, even though we in medical language will consider that chest pain. So our job is trying to figure out between the serious reasons and less serious reasons so that we can focus on time sensitive conditions first. Things that may kill the patient such as heart attacks, blood clots, big arteries rupturing, a popped lung, those are the bad, life threatening things that can cause heart attack. What makes Yale Medicine unique is that our department is the only department in the country that evaluates for small vessel disease in addition to typical heart attacks, which is often undiagnosed reason for recurring chest pain in patients. There are more benign things that can also cause chest pain: acidity or reflux, gallbladder or something in the chest wall, or it could be asthma that can cause pain. Yale Chest Pain Center is an observation unit which is located within the emergency department and what makes us very distinct is that it’s a physical observation unit where emergency medicine and cardiology comes together in offering state-of-the-art facilities for our patients in an integrated way to rule out a heart attack. I’m Dr. Basmah Safdar, I’m associate professor of department of emergency medicine at Yale Medicine.