The Nation's Health + Paramedic

A Heavy Heart

"31 year old male, chest pain"

I really am bored with chest pain. Historically people ignored it, and as such, people having heart attacks didn't get treatment and subsequently died. Cue the huge, expensive campaign to raise awareness about chest pain. It was hugely successfully and cardiac care in this country is now one of the best in the world. However, the increased awareness about chest pain has inevitably led to chest pain being overused as a symptom. It seems that any pain, anywhere on the torso and for any length of time must be a heart attack, and as such, the amount of people who claim to have just pain when calling an ambulance is huge! Some use it to get a quick ambulance because they know we will come immediately. Some, just can't cope with any pain, anywhere and assume they are dying.

I would say that as high as 9 out of 10 chest pains that we go to are not genuine chest pains, which is quite remarkable. We go to them every single shift in some form or another, and very rarely is it a heart attack. As a rule of thumb, I find that chest pain in the under 40's is not genuine chest pain. More often than not it is a panic attack, chest pain caused by prolonged coughing, a stitch or any other common day illness which most normal people treat at home. However, 999 seems to be the first port of call! Obviously, there are exceptions to the rule and we wouldn't want to put people off calling if they are having a heart attack, however, what I can assure you of, is sharp chest pain that is only there each time you cough, is not a heart attack.

It was middle of the day and my shift was ticking away nicely when I got sent a job. I shook my head about a 31 year old calling with chest pain and headed off. There is nothing that can be done about filtering these calls. It is very black and white. 'Do you have chest pain?' 'Yes'. They get an ambulance. Find a solution which removes risk and you'd save all ambulance services millions of pounds!

Waiting at the door with almost a proud grin was the patient. I grabbed my bags, trying my best to avoid eye contact for as long as possible, as I'd seen his beckoning eyebrows dancing round all over the shop! Keep them still man! I eventually got to the door and headed in.

"Right sir, what's the problem today?"

"I have pain in my heart."

"Point with one finger where the pain is"

*points to right side of chest*

"Your heart isn't there."

"You sure?"

"Pretty sure."

"Oh, how odd, is that my stomach then?"


Welcome to my world! Needless to say, he was left at home with advice and 2 Paracetomol! Another life saved!

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