Health adults

Chest pain

Chest pain isn’t always caused by a problem with your heart, but it can sometimes be a symptom of:

  • angina – where the blood supply to the muscles of the heart is restricted
  • a heart attack – where the blood supply to part of the heart is suddenly blocked

The main differences between these conditions is that chest pain caused by angina tends to be triggered by physical activity or emotional stress, and gets better with rest after a few minutes.

Symptoms of a heart attack tend to last more than 15 minutes, occur at rest, and include sweating and vomiting.

If you’ve previously been diagnosed with angina, the pain may be relieved by your angina medication. A second dose can be taken after five minutes if the first dose is not effective.

Chest pain can be associated with symptoms such as

  • dizziness,
  • lightheadedness,
  • shortness of breath,
  • stabbing or burning sensations,
  • squeezing sensation,
  • tightness,
  • sharp or dull pain in chest, neck, or arms, and
  • fatigue.

Common causes of chest pain

Most chest pain is not heart-related and isn’t a sign of a life-threatening problem.

This information should give you an idea of whether these conditions may be causing your chest pain, but you should always seek medical advice to make sure you get a proper diagnosis.

Some common causes of chest pain include:

  • gastro-oesophageal reflux disease (GORD) – a common condition where acid from the stomach comes up into the oesophagus (gullet), causing heartburn and an unpleasant taste
  • a strained muscle in your chest wall – which can be surprisingly painful, but with rest the pain should ease and the muscle will heal in time
  • costochondritis – inflammation of the cartilage that joins the ribs to the breastbone; symptoms include pain, swelling and tenderness around your ribs, and the pain is made worse by lying down, breathing deeply, coughing or sneezing
  • an anxiety or panic attack – which tends to last up to 20 minutes and may also cause symptoms such as heart palpitations, sweating, breathlessness and dizziness
  • lung conditions such as pneumonia or pleurisy – which often cause sharp chest pain that gets worse when you breathe in and out, and are accompanied by other symptoms such as a cough and breathlessness

Other possible causes

There are many other potential causes of chest pain, including:

  • shingles – a viral infection of a nerve and the area of skin around it, which causes a painful rash that develops into itchy blisters
  • mastitis – pain and swelling of the breast, which is usually caused by an infection, most commonly during breastfeeding
  • acute cholecystitis – inflammation of the gallbladder, which can cause a sudden sharp pain in the upper right side of your tummy that spreads towards your right shoulder
  • stomach ulcers – a break in the lining of the stomach, which can cause a burning or gnawing pain in your tummy
  • a pulmonary embolism – a blockage in the blood vessel that carries blood from the heart to the lungs, which can cause sharp, stabbing chest pain that may be worse when you breathe in, as well as breathlessness, a cough and dizziness
  • pericarditis – inflammation of the sac surrounding your heart, which can cause a sudden, sharp and stabbing pain in your chest, or more of a dull ache; the pain usually worsens when lying down

Some of these conditions can be very serious. Make sure you seek medical advice so you can be correctly diagnosed and treated.

How is chest pain diagnosed?

Seek emergency treatment immediately if you think you may be having a heart attack and especially if your chest pain is new, unexplained, or lasts more than a few moments.

Your doctor will ask you questions. Your answers can help them diagnose the cause of your chest pain. Be prepared to discuss any related symptoms and to share information about any medications, treatments, or other medical conditions you may have.

Diagnostic tests

Your doctor may order tests to help diagnose or eliminate heart-related problems as a cause of your chest pain. These may include:

  • an electrocardiogram, which records your heart’s electrical activity
  • blood tests to measure enzyme levels
  • a chest X-ray to examine your heart, lungs, and blood vessels
  • an echocardiogram, which uses sound waves to record moving images of the heart
  • an MRI to look for damage to the heart or aorta
  • stress tests to measure your heart function after exertion
  • an angiogram to look for blockages in specific arteries

How is chest pain treated?

Your doctor might treat chest pain with medication, noninvasive procedures, surgery, or a combination of these methods depending on the cause and severity of your chest pain.

Treatments for heart-related causes of chest pain include:

  • medications, including nitroglycerin and other medications that open partially closed arteries, clot-busting drugs, or blood thinners
  • cardiac catheterization, which involves using balloons or stents to open blocked arteries
  • surgical repair of the arteries, which is also known as coronary artery bypass grafting or bypass surgery

Treatments for other causes of chest pain include:

  • lung re-inflation for a collapsed lung, which your doctor will perform by inserting a chest tube or related device
  • antacids or certain procedures for acid reflux and heartburn
  • anti-anxiety medications for chest pain related to panic attacks

However, chest pain can also be a symptom of a life-threatening condition. Seek immediate medical treatment if you think you may be experiencing a heart attack or another heart problem. This can save your life. Once your doctor diagnoses you, they can recommend additional treatments to manage your condition.

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