Pain, fever, shortness of breath — when are these a temporary bother or something much worse?
You wake up one morning with a fever. Or maybe you have a really bad neck ache. How do you know if a symptom is serious or not? "The things that we doctors are most concerned about are new symptoms that develop quickly, rather than things that develop over a long period of time," says Keith L. Black, M.D., chair of neurosurgery at Cedars-Sinai Medical Center in Los Angeles.
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Another warning sign? That uh-oh feeling that tells you something's not quite right. "You know your body best," says Len Lichtenfeld, M.D., deputy chief medical officer at the American Cancer Society. "When you see or feel something different or just feel 'off,' pay attention; don't dismiss it."
Here are nine symptoms and what they might mean.
Do your symptoms merit a hospital visit? — Getty Images/Blend Images
1. Sudden Intense Headache
The big worries: If you experience head pain unlike any you've had before, especially if it peaks in seconds to minutes in any part of the head, it could signal a ruptured aneurysm, a blood vessel in your brain that suddenly bursts, requiring immediate attention.
In addition, your doctor will want to rule out three other conditions:
- Cardiac cephalgia: A rare disorder in which reduced blood supply to the heart manifests as a headache and can also cause chest pain and exhaustion with exertion.
- Meningitis: A headache often accompanied by a stiff neck, fever and confusion or other changes in mental status.
- Temporal Arteritis: A rare illness in which a person's immune cells invade the walls of the arteries that carry blood to the head, causing headache, low-grade fever or pain upon speaking or chewing. "The reason temporal arteritis is such a concern is that it can result in the temporary or permanent loss of vision in one or both eyes," says Brian Grosberg, M.D., codirector of the Montefiore Headache Center in the Bronx, New York. Steroids usually take care of the problem if treatment is prompt.
What else it might be: Shingles can cause pain in the forehead before the notorious skin reaction (shingles is a painful flare-up of the herpes zoster virus that lies dormant in anyone who's had chicken pox). Contrary to common belief, sudden severe headaches are unlikely to be a sign of a brain tumor. Rather, research shows that two-thirds of patients diagnosed with a brain tumor experienced tension headaches — dull, achy or pressure-like pain — that steadily worsened over a period of weeks to months.
2. Chest Pain
The big worries: Any intense discomfort, heaviness or pressure — like an elephant sitting on your chest — could spell heart attack. It may be combined with pain radiating down an arm, nausea and vomiting, sweating, and shortness of breath. Women can experience more subtle symptoms, like fatigue, a burning sensation or upper abdominal pain. In any case, call 911. "If it is a heart attack, a delay could cause the heart muscle to be damaged," says Eric Topol, M.D., a cardiologist at the Scripps Clinic in La Jolla, California. If these symptoms occur only during exertion, it could also be angina, which happens when the heart muscle temporarily doesn't get enough blood.
Sudden severe chest or upper-back pain (often described as a ripping sensation) can be caused by a tear in the aorta, known as aortic dissection, which requires immediate attention. Fortunately, this life-threatening condition occurs in only about three out of 100,000 people.
What else it might be: "Perhaps 10 to 20 percent of cases of intense chest pain are due not to heart trouble but to gastrointestinal reflux disease [GERD]," says Topol. Rarely, it could also signal esophageal spasm, an abnormal contraction of the muscles in the esophagus, which carries food from the throat to the stomach. Both conditions can be treated with medications, but it's always wise to go to the ER: "It's a heart attack or angina until proven otherwise," Topol says.
