Chest Pain

Chest pain is any discomfort felt between your neck and upper belly. It can be sharp, dull, burning, crushing or tight, and may stay in one place or spread elsewhere. Causes range from the harmless to the life-threatening, so chest pain should always be taken seriously.

No. Chest pain has many causes besides the heart — including the digestive system, muscles, lungs and anxiety. But because it can signal a heart attack, and you cannot reliably tell the cause yourself, sudden or severe chest pain must be treated as a possible emergency until a clinician says otherwise.

Classic heart-attack symptoms include pain, pressure, tightness or squeezing in the centre or left of the chest that lasts more than a few minutes or comes and goes, and may spread to one or both arms, the neck, jaw, back or stomach. It is often accompanied by breathlessness, a cold sweat, nausea or light-headedness.

Symptoms are not the same for everyone — women, older people and people with diabetes may have less typical signs, such as unusual tiredness or breathlessness rather than 'classic' chest pain.

Many cases are not from the heart. Frequent causes include heartburn (acid reflux) and other digestive problems, a strained chest muscle or inflammation where the ribs meet the breastbone, lung problems such as infection or pleurisy, and anxiety or panic attacks. A blood clot in the lung is a more serious lung cause. Because these can feel similar, the underlying problem is often not obvious without assessment.

A clinician starts with your history and an examination, then may use an ECG and blood tests (such as troponin) to check the heart, along with imaging like a chest X-ray or CT scan. The right tests depend on your symptoms and risk factors.

If you have called emergency services for suspected heart-attack symptoms, stay as calm and still as you can, sit or lie in a comfortable position, and loosen tight clothing. Follow the operator's advice — they may give guidance about aspirin, but only take medication on their or a clinician's instruction. If the person becomes unresponsive and is not breathing normally, the operator can talk you through CPR.

Call your local emergency number (such as 112, 999 or 911) immediately for chest pain that is sudden, severe, crushing or tight, that lasts more than a few minutes or keeps returning, or that comes with breathlessness, sweating, nausea, or pain spreading to the arm, neck or jaw. Do not wait to see if it passes, and do not drive yourself — rapid treatment saves lives.

New, recurring or unexplained chest pain that is not an emergency should still be assessed by a doctor reasonably promptly — especially if it comes on with exertion and eases with rest (a possible sign of angina), or if you have risk factors such as high blood pressure, high cholesterol, diabetes, smoking or a family history of heart disease.