In light of the tragic passing of long time NFL and NCAA coach Tony Sparano on Sunday July 22nd, a quick review of chest pain seemed to be timely and appropriate.
The first thing that needs to be said is chest pain is not a medical diagnosis. Chest pain is a symptom. It means it is treated by medical personnel like elevated blood pressure or an elevated temperature, a clue as to what maybe going on with a patient.
When people hear chest pain, most people assume this means heart attack, but in an emergency department/hospital setting heart attack or acute myocardial infarction as it is known in the medical community is only 1 of a whole list of conditions that include some type of chest pain as a symptom.
CHEST PAIN – Possible Diagnoses
- Acute Cardiac Syndrome – Acute Myocardial Infarction
- Chest Wall Pain – musculoskeletal pain that is reproducible when chest is palpated
- GERD – Gastroesophageal Reflux Disease (heartburn)
- Panic Disorder or Acute Anxiety Attack
- Pneumonia or Bronchitis
- Pericarditis – this is diagnosed based on the presence of a triad of symptoms and is not common
- Pulmonary Embolism – this is related to a blood clot in the lungs
- Heart Failure – generally occurs in patients with a history of previous myocardial infarction
A lot of people posted on various social media sites that Coach Sparano was admitted for chest pain and discharged the next day without proper diagnosis and died 2 days later so therefore the doctors didn’t do their job properly.
This is not an accurate assessment and most likely, he was discharged because the initial workup was found to be negative and based on current guidelines under which medical professionals are trained, the risk of remaining in the hospital was greater than the risk of an acute life threatening event occuring in the 24-72 hours after discharge.
Several algorithms are used, but basically if the initial workup is negative, patients are discharged home with follow up for further testing as outpatients scheduled in the week following discharge. This testing can include advanced cardiac testing and if deemed necessary, based on the results of these tests, more invasive procedures like cardiac catheterization and angioplasty.
Chest pain is a complex symptom. The loss of Coach Sparano was a shock to everyone, but if you experience chest pain which is associated with heavy sweating and/or worse with exertion, are over the age of 40, have a family history of cardiac disease, have other conditions like obesity, diabetes, & hypertension, you are a current or former smoker or have had a previous myocardial infarction you should go to the closest emergency room, your family doctor or call 911 so you can be evaluated ASAP.
Coach did exactly what he was supposed to but sometimes bad things happen to good people despite the best efforts to the contrary.
Finally, my heartfelt condolences go out to the Sparano family and #Vikings everywhere. Rest in Peace Coach Sparano, You will have a seat on the 50 yard line in heaven for eternity.