About Chest Pain- Chest pain is discomfort, pressure, tightness, or pain felt in any area of the chest. It can occur for many different reasons, ranging from relatively minor problems such as indigestion, muscle strain, or anxiety to serious and potentially life-threatening conditions such as a heart attack, aortic dissection, or pulmonary embolism. Chest pain may feel like pressure, squeezing, burning, heaviness, stabbing, aching, or tightness. It may be felt only in the chest or may spread to the back, neck, jaw, shoulders, or arms. Although chest pain is not always related to the heart, new, severe, unexplained, or persistent chest pain should never be ignored.
Chest pain can vary considerably depending on its cause. Symptoms may include:
A burning sensation in the chest
Chest pressure, heaviness, or tightness
Sharp, stabbing, dull, aching, or burning pain
Pain that gets worse with physical activity
Pain that changes with body position
Pain that spreads to the arm, shoulder, back, neck, or jaw
Back pain that may radiate toward the front of the chest
Shortness of breath
Cold sweats
Dizziness or lightheadedness
Weakness or unusual fatigue
Nausea or vomiting
Difficulty swallowing
A sour or acidic taste in the mouth
Abdominal discomfort or pain
Not everyone experiences typical symptoms during a heart attack. Older adults, women, and people with diabetes may sometimes have less typical symptoms, such as unusual tiredness, shortness of breath, nausea, or discomfort in the back or jaw.
The sensation of chest pain can differ from person to person. It may be described as:
Pressure: A feeling that something heavy is sitting on the chest.
Tightness: A squeezing or constricting sensation.
Burning: A sensation similar to heartburn or indigestion.
Stabbing: A sharp or piercing pain.
Aching: A persistent soreness or dull discomfort.
Heaviness: A feeling of weight or pressure in the chest.
The way chest pain feels can provide clues about its cause, but the sensation alone cannot reliably determine whether chest pain is harmless or dangerous.
Angina occurs when the heart muscle does not receive enough oxygen-rich blood, usually because of narrowed coronary arteries. It may cause pressure, squeezing, heaviness, or discomfort in the chest, particularly during physical activity or emotional stress.
A heart attack (myocardial infarction) occurs when blood flow to part of the heart muscle becomes blocked. Chest pressure or pain is a common symptom, but a heart attack can also cause shortness of breath, sweating, nausea, dizziness, or pain spreading to the arm, back, neck, or jaw. A suspected heart attack requires immediate emergency medical attention.
An aortic dissection occurs when a tear develops in the inner layer of the aorta, the body’s main artery. It can cause sudden, severe chest or upper back pain and is a medical emergency.
Pericarditis is inflammation of the sac surrounding the heart. It can cause sharp chest pain that may become worse when taking a deep breath or lying down and may improve when sitting forward.
Cardiomyopathy refers to diseases affecting the heart muscle. Depending on the type, it may cause chest discomfort, shortness of breath, fatigue, swelling, or abnormal heart rhythms.
A pulmonary embolism occurs when a blood clot, usually originating in a deep vein of the leg, travels to the lungs and blocks a blood vessel. Symptoms may include sudden shortness of breath, chest pain that can worsen with breathing, rapid heartbeat, dizziness, or coughing up blood. A pulmonary embolism can be life-threatening and requires urgent medical care.
A pneumothorax, commonly called a collapsed lung, occurs when air enters the space between the lung and chest wall. It may cause sudden chest pain and shortness of breath.
Pneumonia is an infection of the lungs. It may cause chest pain, especially when breathing deeply or coughing, along with fever, cough, chills, and difficulty breathing.
Asthma and bronchospasm can cause chest tightness, wheezing, coughing, and difficulty breathing. The chest discomfort may occur during or after an asthma attack.
Acid reflux occurs when stomach acid flows back into the esophagus. It can cause a burning sensation behind the breastbone, an acidic or sour taste in the mouth, and discomfort that may become worse after eating or when lying down.
Pancreatitis, or inflammation of the pancreas, generally causes significant upper abdominal pain that may radiate to the back. In some cases, the discomfort can be perceived in the chest.
Costochondritis is inflammation where the ribs connect to the breastbone. It can cause localized chest pain and tenderness and may become worse with movement, deep breathing, or pressing on the affected area.
Strained or sore muscles in the chest, shoulders, or back can cause pain or tenderness. The discomfort may be related to physical activity, lifting, exercise, or injury.
A panic attack can cause chest pain or tightness along with a racing heartbeat, sweating, trembling, shortness of breath, dizziness, or a feeling of intense fear. Because panic attacks can produce symptoms that resemble those of a heart attack, new or unexplained chest pain should be medically evaluated rather than automatically attributed to anxiety.
The likelihood of a serious cardiovascular cause may be higher in people with certain risk factors, including:
Increasing age
Smoking or tobacco use
High blood pressure
High cholesterol
Diabetes
Obesity
Physical inactivity
A family history of heart disease
Previous heart disease or stroke
Known coronary artery disease
Having one or more risk factors does not mean that chest pain is necessarily caused by the heart, but it makes appropriate medical assessment particularly important.
Because chest pain has many possible causes, a healthcare professional will usually begin by taking a detailed medical history and performing a physical examination. The doctor may ask about:
When the pain started
Where the pain is located
What the pain feels like
How long it lasts
Whether it spreads to another part of the body
Whether it occurs during physical activity or at rest
Whether breathing or body position changes the pain
Associated symptoms such as sweating, nausea, dizziness, or shortness of breath
Existing medical conditions and medications
Cardiovascular risk factors
Depending on the symptoms and suspected cause, investigations may include:
Electrocardiogram (ECG/EKG) to evaluate the heart’s electrical activity
Blood tests, including cardiac biomarkers such as troponin when a heart attack is suspected
Chest X-ray
Echocardiogram
Stress testing
CT scan
CT coronary angiography
Coronary angiography
Other tests based on the suspected cause
The tests required depend on the person’s symptoms, medical history, examination findings, and risk of serious disease.
Treatment depends entirely on the underlying cause. There is no single treatment for all types of chest pain. Depending on the diagnosis, treatment may include:
Medicines for heart disease or angina
Emergency treatment for a heart attack
Medicines to treat acid reflux or heartburn
Antibiotics when a bacterial infection is diagnosed
Inhaled medicines for asthma or bronchospasm
Pain-relieving medicines for certain musculoskeletal conditions
Treatment for panic attacks or anxiety when appropriate
Anticoagulant treatment for certain blood clots
Treatment for pneumonia or other lung conditions
Surgical or catheter-based procedures for certain cardiovascular conditions
Serious conditions such as heart attack, pulmonary embolism, pneumothorax, or aortic dissection require urgent medical treatment. Do not take prescription heart medicines or blood-thinning medicines on your own simply because you have chest pain. Treatment should be guided by a healthcare professional.
You should seek medical evaluation for chest pain that is:
New or unexplained
Recurrent
Persistent
Becoming more frequent or severe
Associated with physical activity
Accompanied by breathing difficulty, dizziness, nausea, sweating, or weakness
Associated with a history of heart or lung disease
Seek emergency medical care immediately for sudden, severe, persistent, or unexplained chest pain, particularly when it occurs with shortness of breath, sweating, fainting, nausea, or pain spreading to the arm, back, neck, or jaw.
No. Chest pain can result from heart, lung, digestive, musculoskeletal, or psychological conditions. However, because some heart-related causes are potentially life-threatening, new or unexplained chest pain should not be ignored.
It can be difficult to distinguish heartburn from a heart attack based only on symptoms. Both may cause burning or discomfort in the chest. A heart attack may also cause pressure, squeezing, shortness of breath, sweating, nausea, dizziness, or pain spreading to the arm, back, neck, or jaw.
If you are unsure, seek emergency medical care rather than assuming that the pain is heartburn.
Gas and digestive problems can cause discomfort that may be felt in the chest. However, chest pain should not automatically be attributed to gas, especially if it is new, severe, persistent, or associated with other warning symptoms.
Yes. Anxiety and panic attacks can cause chest tightness or pain along with rapid heartbeat, sweating, dizziness, and shortness of breath. However, chest pain should not automatically be assumed to be caused by anxiety without appropriate medical assessment.
Even brief chest pain may require medical assessment, particularly if it is new, recurrent, occurs during physical activity, or is associated with other symptoms. Angina, for example, can cause episodes of chest discomfort that come and go.
Yes. Acid reflux can cause burning chest discomfort commonly known as heartburn. It may be accompanied by a sour or acidic taste in the mouth and may become worse after eating or lying down. However, heart-related chest pain can sometimes feel similar.
Not necessarily, but chest pain that occurs during physical activity can be a warning sign of angina or another cardiovascular problem and should be evaluated by a healthcare professional.
Medical Disclaimer: This information is intended for general educational purposes and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Chest pain can sometimes indicate a medical emergency. If you have sudden, severe, persistent, or unexplained chest pain, particularly with shortness of breath, sweating, fainting, nausea, or pain spreading to the arm, back, neck, or jaw, seek emergency medical attention immediately.
