About this symptom
Chest pain is pain, pressure or tightness in the front of the body, between the neck and the upper tummy. It can come from the heart, lungs, food pipe, muscles, ribs or nerves.
The causes range from harmless to life-threatening, and most chest pain is not serious. But the cause cannot be worked out at home, and a heart attack can feel like indigestion. Rarer serious causes include a collapsed lung and a tear in the main blood vessel from the heart.
Possible causes
This is not a diagnosis. These are the causes doctors think about, with the ones that are most urgent to rule out first.
- Heart attackPressure, tightness or squeezing in the centre or left of the chest, often spreading to the arm, jaw or back, with sweating or breathlessness. It can feel like indigestion.Read about it
- Coronary artery diseaseCan cause angina: chest tightness that comes on with effort and settles within minutes of rest. Pain at rest, or stronger or longer than usual, is an emergency.Read about it
- Pulmonary embolismA blood clot in the lung. Sudden sharp pain with breathlessness, especially after a long journey or bed rest, or with a swollen leg.Read about it
- PneumoniaSharp pain that is worse when you breathe in or cough, often with a high temperature and yellow or green phlegm.Read about it
- Acid refluxBurning in the chest that starts after eating, with a sour taste or food coming back up, and a full, bloated feeling. A heart attack can feel similar.Read about it
- AnxietyOften a sharp, steady pain brought on by worry or stress, with a racing heartbeat, sweating, dizziness and fast breathing. A first episode still needs checking.Read about it
- Strained chest muscleStarts after a chest injury or hard exercise, may hurt more when you breathe in, and eases when the muscle rests.
- CostochondritisSoreness where the ribs join the breastbone, which may hurt more when you press on it or move. A doctor needs to rule out the heart before settling on this.
When to get help
Also get emergency care for:
- Pain that keeps returning within hours, or (chest pain on effort) that is stronger, longer or comes at rest
- Sudden sharp pain with breathlessness, especially after a long journey or bed rest, or with a swollen leg
- Sudden severe pain in the chest and upper back
- Someone who has collapsed or is not breathing normally: call for help and start CPR if you know how
See a doctor soon if you have:
- Chest pain that comes and goes, or passed quickly but still worries you
- Chest pain on effort that settles within minutes of rest
- Pain on breathing in or coughing, with fever or yellow or green phlegm
- Burning after meals, a sour taste or trouble swallowing
- Pain that has lasted more than a few days
If the pain has an obvious cause, such as a strained muscle, is easing and none of these signs apply, it can wait for a routine visit.
What you can do at home
With any emergency sign, do not stay at home: call for an ambulance first, and follow any advice the operator gives.
Do
- Sit down, rest and have someone stay with you
- Note when the pain began and what you were doing
Do not
- Do not wait to see if the pain passes, or delay the call to look for medicines
- Do not drive yourself to hospital
- Do not take an antacid or pain-relief tablet to test whether it settles
Because the cause is often hard to tell, check with a doctor before treating chest pain yourself at home.
What the doctor will do
The doctor will ask where the pain is, what it feels like, how long it lasts, whether it spreads, and what changes it, such as effort, rest or breathing. They will ask about smoking, , diabetes and , and examine you.
Tests depend on the likely cause. They may include:
- An , a quick recording of the heart's electrical activity, usually the first test if a heart attack is possible
- Blood tests, including , a protein that leaks out when heart muscle is damaged
- A chest X-ray or
- A stress test, to see how the heart copes with effort
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“It is only gas or acidity. Take an antacid or a soda and see if it passes.”What is true?
Fact
A heart attack can feel like burning or indigestion, and the two cannot be told apart at home. If the pain is sudden and does not go away, or comes with sweating, breathlessness or pain spreading to the arm, jaw or back, call for an ambulance rather than waiting to see if the antacid helps.
Myth“Heart pain is always on the left side, so pain anywhere else cannot be the heart.”What is true?
Fact
Pain from the heart is felt most often in the centre or left of the chest, but it can also spread to either arm, the shoulders, neck, jaw, back or upper tummy. The side of the pain is not a safe guide, so go by the other signs.
Myth“The pain has gone, so it was nothing.”What is true?
Fact
Pain that comes and goes, or passes quickly, can still be a sign of a heart problem such as angina, and heart attack symptoms can also come and go over several hours. See a doctor soon, and call for an ambulance if the pain keeps coming back or comes with other emergency signs.
Myth“Taking the person to hospital by car or auto is better than waiting for an ambulance.”What is true?
Fact
An ambulance is the safest way to get help, because the crew can begin tests and treatment right away. Do not drive yourself to hospital, and do not wait to see if the pain passes before you call.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
How can I tell whether chest pain is from the heart or from gas?
You cannot reliably tell at home, because a heart attack can feel like burning or indigestion. Pain that starts after eating, with a sour taste or food coming back up, points more towards acid reflux. But if the pain does not go away, or comes with sweating, breathlessness, feeling sick or pain spreading to the arm, jaw or back, call for an ambulance.
The pain went away after a few minutes. Do I still need to see a doctor?
Yes. Pain that comes and goes or passes quickly can be angina or another problem, so see a doctor soon. Heart attack pain can also ease and return, so if it keeps coming back or comes with any emergency sign, call for an ambulance.
Can stress or anxiety really cause chest pain?
Yes. Anxiety or a panic attack can cause a sharp, steady chest pain with a racing heartbeat, sweating and dizziness. But a heart problem can feel similar, so do not decide on your own that it is stress. Have a first episode checked, and call for an ambulance if any emergency sign is present.
What should I do while waiting for the ambulance?
Sit down, rest and have someone stay with you. Follow any advice the ambulance operator gives. Do not take an antacid or pain-relief tablet to test whether the pain settles, and do not delay the call to look for medicines. If the person collapses and is not breathing normally, start CPR if you know how.
