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Cardiolucent

Condition

Chest pain

Symptoms & Risk Factors

Chest pain is one of the most important symptoms in medicine because the differential ranges from completely benign to immediately life-threatening. Cardiac causes — coronary artery disease, pericarditis, myocarditis, aortic dissection, valve disease — must be excluded or addressed promptly, but most chest pain in the outpatient setting ultimately turns out to be musculoskeletal, gastroesophageal, anxiety-related, or pulmonary. The cardiologist's job is to make that distinction efficiently and safely, ruling out the dangerous causes first and then helping you understand what is actually driving the symptom. Dr. Kedan evaluates every chest pain presentation as both a diagnostic and a risk-stratification question, using POCUS, EKG, and biomarkers at the visit and adding stress testing or coronary CT when appropriate.

What Cardiolucent Evaluates

  • Detailed symptom characterization: quality, location, radiation, triggers, duration, relieving factors
  • Resting 12-lead EKG and POCUS at the visit for immediate cardiac and pericardial assessment
  • Troponin and cardiac biomarker testing when acute symptoms are present
  • Full echocardiography with strain imaging when structural disease is suspected
  • Stress echocardiography, nuclear stress, or coronary CT angiography matched to your presentation
  • Coronary calcium scoring for risk refinement in selected patients
  • Evaluation for non-cardiac contributors including reflux, musculoskeletal causes, and anxiety
  • Coordination with Cedars-Sinai catheterization when invasive evaluation is indicated

What Patients Describe

  • Pressure, tightness, squeezing, or heaviness in the center of the chest (classic cardiac pattern)
  • Burning or sharp discomfort that may be reflux-related
  • Discomfort radiating to the left arm, jaw, neck, shoulder blades, or back
  • Shortness of breath, nausea, sweating, or lightheadedness accompanying the chest discomfort
  • Symptoms reliably triggered by exertion, emotional stress, cold air, or heavy meals and relieved by rest
  • Sharp pain worse with deep breathing or position changes (suggestive of pericarditis or musculoskeletal causes)
  • Tearing or ripping pain radiating to the back is an aortic dissection emergency — call 911
  • Any severe, sustained, or rest-occurring chest pain should be treated as a heart attack until proven otherwise

Possible Underlying Causes

  • Coronary artery disease, including stable angina and acute coronary syndromes
  • Pericarditis and myocarditis (inflammatory chest pain)
  • Aortic dissection (rare but life-threatening)
  • Valvular heart disease, particularly aortic stenosis
  • Pulmonary embolism
  • Gastroesophageal reflux and esophageal spasm
  • Musculoskeletal causes including costochondritis and intercostal strain
  • Panic and anxiety disorders, sometimes coexisting with cardiac disease
  • Shingles (zoster) in early stages before rash appears
  • Less commonly: gallbladder disease, pleuritis, pneumonia

How We Investigate

Dr. Kedan's approach is to exclude the dangerous causes first, then refine the diagnosis. The first visit typically includes a careful history, EKG, POCUS, and labs as appropriate, often answering the most pressing questions in the same appointment. Stress echocardiography, coronary CT, or coronary calcium scoring are added when needed for risk stratification, and Cedars-Sinai is engaged for catheterization when invasive evaluation is indicated. The concierge model is structured around same-day or next-day evaluation for new cardiac symptoms — chest pain is exactly the kind of symptom that benefits from that access. For active, severe, or escalating chest pain, do not wait for an appointment; call 911.

Common Questions

Frequently Asked Questions

When is chest pain an emergency?
Sudden, severe chest pain or pressure — particularly when it lasts more than a few minutes, radiates to the jaw, neck, arm, or back, or is accompanied by shortness of breath, sweating, nausea, or lightheadedness — should be treated as a heart attack until proven otherwise. Call 911 rather than drive yourself. Time-sensitive care saves heart muscle and lives.
Is chest pain always a heart problem?
No. Reflux, musculoskeletal strain, anxiety, lung issues, and gallbladder disease can all cause chest pain that mimics cardiac symptoms. A careful history and targeted testing usually distinguish these, and ruling out cardiac causes is part of safely attributing pain to something else. Dr. Kedan focuses first on excluding dangerous causes, then refining the differential.
What does cardiac chest pain typically feel like?
Classic cardiac chest pain is described as pressure, squeezing, tightness, or burning, often substernal, sometimes radiating to the arm, neck, or jaw, and frequently brought on by exertion or stress and relieved by rest. That said, presentations vary — women, older adults, and people with diabetes often have less typical symptoms such as fatigue or shortness of breath. Atypical does not mean benign.
What tests will be done to evaluate chest pain?
Evaluation usually starts with a focused history and physical, an EKG, and cardiac biomarkers such as troponin when acute symptoms are present. Stress echocardiography is commonly used for ischemia evaluation, and coronary calcium scoring or coronary CT angiography may be added for risk stratification. POCUS during the visit provides immediate insight into cardiac structure and pericardial issues.
What is a stress echocardiogram, and why might I need one?
A stress echocardiogram combines exercise (or pharmacologic stress) with ultrasound imaging of the heart, allowing Dr. Kedan to see how the heart muscle responds under load. It is highly informative for detecting reduced blood flow to specific coronary territories without the radiation of nuclear imaging. Results help determine whether further testing or intervention is needed.
What if my tests are normal — does that mean my chest pain is nothing?
A normal cardiac workup is reassuring but does not always end the conversation. Non-cardiac causes still deserve attention, particularly if symptoms are persistent or interfering with daily life. Dr. Kedan helps you interpret the results, identify next steps with the appropriate specialist, and decide whether ongoing cardiac surveillance is appropriate.
Can chest pain come from inflammation rather than blockage?
Yes. Pericarditis (inflammation of the sac around the heart) and myocarditis (inflammation of the heart muscle) can both cause chest pain, often sharp and worse with breathing or lying flat. These conditions have distinct treatments and require accurate diagnosis. Echocardiography, biomarkers, and sometimes cardiac MRI help distinguish them from ischemic chest pain.
How is cardiac chest pain treated?
Treatment depends on the underlying cause. Coronary disease is managed with optimal medical therapy and, when necessary, stenting or bypass coordinated with Cedars-Sinai specialists. Pericarditis is treated with anti-inflammatories and addressed at its source. Dr. Kedan builds the regimen around the actual diagnosis rather than treating the symptom in isolation.
How quickly can I be evaluated?
Cardiolucent's concierge model is built around timely access — Dr. Kedan reserves capacity for same-day or next-day evaluation of new cardiac symptoms. For active, severe, or escalating chest pain, do not wait for a clinic appointment; call 911. For more stable or recurrent chest pain, call (310) 304-5555 to arrange a prompt visit.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.