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Chest pain

Chest pain is any discomfort, pressure, or ache you feel in your chest area, from your neck to your upper abdomen. It can range from harmless to life-threatening.

Common causes of chest pain

Chest pain isn’t always heart-related. It’s often grouped by source.

1. Heart and blood vessel causes

  • Angina: Pressure or squeezing from reduced blood flow to the heart. Often triggered by exertion and relieved by rest.
  • Heart attack (myocardial infarction): Blocked blood flow to the heart. Pain may feel like crushing, tightness, or heaviness, often with shortness of breath, sweating, nausea, or pain radiating to the arm, jaw, or back.
  • Pericarditis: Inflammation of the sac around the heart. Sharp pain that worsens lying down or breathing deeply.
  • Aortic dissection: Tearing of the body’s main artery. Sudden, severe, tearing pain in the chest or back.
  • Pulmonary embolism: Blood clot in the lungs. Sudden sharp pain, often with shortness of breath and coughing.
  • Pneumonia or pleurisy: Lung infection, or inflammation of the lining. Sharp pain that worsens with breathing or coughing.
  • Pneumothorax: Collapsed lung. Sudden sharp pain and shortness of breath.

3. Digestive causes

  • Acid reflux (GERD): Stomach acid backs up into the esophagus. Burning pain after eating, worse lying down.
  • Esophageal spasm: Sudden, intense squeezing pain; it can mimic heart pain.
  • Gallstones or pancreatitis: Pain may radiate to the chest from the upper abdomen.

4. Muscle, bone, or nerve causes

  • Costochondritis: Inflammation where the ribs meet the sternum. Sharp, localized pain, worsened by pressing on the area.
  • Muscle strain: From heavy lifting, coughing, or injury. Tender to touch.
  • Shingles: Burning pain before a rash appears along the nerve path.

5. Anxiety and panic

  • Panic attack: Tightness, rapid heartbeat, shortness of breath, and fear. The pain itself isn’t dangerous, but it can feel identical to that of the heart.

When to go to the emergency

Go to the emergency service of a hospital when there are symptoms like:

  • Sudden crushing, squeezing, or heavy pressure.
  • Pain spreading to the arm, jaw, neck, back, or stomach.
  • Shortness of breath, sweating, nausea, dizziness, or fainting.
  • Pain lasting more than a few minutes, or that comes and goes.
  • New pain during rest or with minimal exertion.
  • An irregular or very fast heartbeat.

When it’s less urgent but still needs attention

See a physician promptly if:

  • The pain is recurring, even if mild.
  • The pain worsens with eating, breathing, or specific movements.
  • You have risk factors: smoking, high blood pressure, diabetes, high cholesterol, or a family history of heart disease.

Investigation

  1. History and examination: What the pain feels like, its triggers, and your risk factors.
  2. ECG: Measures the heart’s electrical activity.
  3. Blood tests: Troponin levels can show heart muscle damage.
  4. Imaging: Chest X-ray, CT, or stress tests, depending on suspicion.

Managing and preventing chest pain

Treatment depends entirely on the cause. Heart-related pain may need medicines, stents, or surgery. GERD is treated with antacids and diet changes. Muscle pain responds to rest, heat or ice, and anti-inflammatories.

For overall heart health: don’t smoke, manage blood pressure and cholesterol, exercise regularly, maintain a healthy weight, and limit alcohol.

Conclusion

Chest pain is always worth taking seriously, because some causes are time-sensitive. If you’re unsure whether your symptoms are dangerous, it’s safer to get checked.

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