Yes, mild chest pains after submerging your hands in very cold water can be a symptom of mitral valve problems — including a relatively harmless mitral valve prolapse. This occurs when the valve between your heart’s left upper chamber (left atrium) and left lower chamber (left ventricle) doesn’t close properly. Often people with mitral valve problems have what is called dysautonomia, or a hyperactive autonomic nervous system. Not only do their feet and hands get cold very easily, but sometimes putting their hands in cold water or simply touching something cold causes a coronary spasm, or tightening of the muscle. This may be another autonomic response that you appear to be experiencing. What is suggested by your symptoms is that your blood vessels are sensitive to the cold. But don’t automatically assume you have mitral valve problems. There could be other reasons for your sensitivity, including chronically low blood pressure or Raynaud’s disease, which affects blood flow to the extremities (although Raynaud’s typically wouldn’t cause chest pain). Given your family history and the fact that this happens every time you touch something cold, I would suggest two things: Q2. I’ve recently decided to start jogging in the mornings, but a few minutes after I start at a light pace, I get a pain in my chest. I can still breathe, but it hurts. And after I stop, it slowly goes away. It’s pretty chilly in the mornings, and I’ve experienced this before when I’ve tried running while it’s cold. However, I can work myself a lot harder doing cardio in a gym and not experience any pain. I’m wondering if this is just caused by the cold or if it’s something more serious that I should have checked out? — Julia, Canada I think that you should absolutely see your doctor about this, Julia. From what you’ve written, your symptoms may indicate stable angina. This is chest pain that results from inadequate blood flow through the coronary arteries during exercise, when increased blood flow is required to supply your working heart muscle. Cold weather can induce a narrowing of the “smooth” muscle in the walls of your heart’s arteries, and it may induce chest pain — even when the same amount of exercise in the warm indoors would not. Cold temperatures can also cause spasms of the smooth muscle that surrounds the small airways in your lungs, which can produce shortness of breath and a feeling of chest heaviness that is unrelated to your heart. The important thing is to make sure that your pain does not represent underlying coronary artery disease that can lead to a heart attack. So, please see your doctor promptly. Q3. Can you help me to identify when I should go to the emergency room? For example, yesterday I woke up with my back and chest feeling as though it was in a vise, and I could not breathe deeply because of the pressure in my chest. I have just been diagnosed with asthma and I also have arthritis, inflammatory spondylitis and fibromyalgia. So I don’t know when it’s one or the other. In a complicated case like yours, when there are multiple medical ailments, it is difficult to differentiate chest pain. Therefore any form of persistent chest pain must be evaluated by a medical professional and an emergency room visit is warranted. As time passes, you may find that each ailment is associated with a specific type of pain. As this becomes more apparent to you, it may alleviate the need for an ER visit. Of course, it is important also to remember that chest pain may be due to causes other than your currently diagnosed conditions, such as heart disease. Learn more in the Everyday Health Heart Health Center.