Chest Pain

What It Is

Chest pain is a symptom, not a diagnosis. It describes any pain, pressure, burning, aching, or tightness felt in the chest area. People describe it in many ways, and the same cause can feel different from one person to another.

Because the chest contains the heart, lungs, major blood vessels, the esophagus, and the chest wall, there are many possible sources. Some causes are minor and short-lived, while others, such as a heart attack or a blood clot in the lungs, are life-threatening and time-sensitive.

For this reason, medical organizations generally advise that new, unexplained, or severe chest pain be evaluated promptly by a healthcare professional rather than judged on its own.

Common Terminology

Angina

Chest pain or pressure caused by reduced blood flow to the heart muscle, often brought on by physical effort or stress.

Myocardial infarction

The medical term for a heart attack, when part of the heart muscle is damaged because its blood supply is blocked.

Pulmonary embolism

A blood clot that travels to and blocks an artery in the lungs.

Pericarditis

Inflammation of the thin sac that surrounds the heart, which can cause sharp chest pain.

Costochondritis

Inflammation of the cartilage that connects the ribs to the breastbone, causing chest wall tenderness.

Acid reflux

Stomach acid flowing back into the esophagus, which can cause a burning feeling in the chest often called heartburn.

Common Causes and Associations

Chest pain is commonly associated with a wide range of conditions. This list is general education and is not a way to identify the cause of any individual case.

• Heart-related causes, such as angina, heart attack, pericarditis, or inflammation of the heart muscle.
• Lung-related causes, such as pneumonia, pleurisy, a collapsed lung (pneumothorax), or a pulmonary embolism.
• Blood vessel causes, such as a tear in the wall of the aorta (aortic dissection), which is rare but serious.
• Digestive causes, such as acid reflux, esophageal spasm, gallbladder problems, or stomach ulcers.
• Muscle, bone, and nerve causes, such as strained chest muscles, rib injuries, costochondritis, or shingles.
• Anxiety and panic attacks, which can cause chest tightness along with a racing heart and rapid breathing.

Symptoms and Features

This is a general description of how this symptom is often described, not a diagnostic checklist.

• Chest pain may be described as pressure, squeezing, tightness, burning, stabbing, or a dull ache.
• It may stay in one spot or spread to the arms, shoulders, neck, jaw, back, or upper abdomen.
• It can be constant or come and go, and may change with breathing, movement, eating, or position.
• It sometimes occurs with other symptoms such as shortness of breath, sweating, nausea, lightheadedness, or a fast heartbeat.
• Women, older adults, and people with diabetes are more likely to have less typical heart attack symptoms, such as fatigue, nausea, or back or jaw discomfort.

Tests and Evaluation

Clinicians commonly use a combination of history, physical exam, and tests to look for the source of chest pain.

• An electrocardiogram (ECG or EKG), which records the heart's electrical activity.
• Blood tests, such as troponin, which can show signs of heart muscle injury.
• A chest X-ray to look at the lungs, heart size, and chest structures.
• A CT scan, which may be used to look for blood clots in the lungs or problems with the aorta.
• Stress testing or an echocardiogram (heart ultrasound) to assess how the heart works.
• Tests of the digestive tract, such as an upper endoscopy, when a digestive cause is being considered.

Treatment Overview

Treatment depends entirely on the underlying cause identified by a healthcare professional.

• Heart-related causes may be treated with medicines, procedures to restore blood flow, and long-term risk factor management.
• Lung-related causes may be treated with approaches such as antibiotics for infection, blood thinners for clots, or procedures for a collapsed lung.
• Digestive causes are often managed with lifestyle changes and medicines that reduce stomach acid.
• Muscle and chest wall causes often improve with rest and general pain relief measures.
• Anxiety-related chest pain may be addressed with counseling, stress management, and sometimes medication.

When Professional Care May Be Discussed

Medical organizations generally describe the following situations as reasons for urgent or prompt evaluation.

• Chest pain that is sudden, severe, or comes with shortness of breath, sweating, nausea, or fainting is generally treated as a medical emergency; in the US, people are advised to call 911.
• Chest pressure or squeezing that spreads to the arm, jaw, neck, or back and lasts more than a few minutes is a commonly described heart attack warning sign.
• Sudden sharp chest pain with trouble breathing, especially after surgery, long travel, or immobility, is generally treated as urgent.
• New chest pain that comes on with exertion and eases with rest is commonly evaluated by a healthcare professional.
• Chest pain that keeps returning or is not explained is generally discussed with a healthcare professional.

Questions to Ask a Healthcare Professional

General questions people often find useful to bring to an appointment:

• What are the most common causes of chest pain?
• How do clinicians tell the difference between heart-related and non-heart-related chest pain?
• What tests are commonly used to evaluate chest pain?
• What are the typical warning signs of a heart attack?
• Can acid reflux or anxiety cause chest pain that feels like a heart problem?
• What risk factors are linked to heart-related chest pain?

Sources

This guide was written in plain language from the following authoritative references.

1. Chest Pain — MedlinePlus (U.S. National Library of Medicine)
2. Chest pain — NHS (UK National Health Service)
3. Heart Attack — MedlinePlus (U.S. National Library of Medicine)

Related Guides

• SymptomsWhen Chest Pain Requires Medical AttentionGeneral education on chest pain warning signs that medical organizations describe as emergencies, and when chest pain is commonly evaluated.
• SymptomsShortness of BreathGeneral information about shortness of breath (dyspnea): common associated causes, how it is evaluated, and warning signs treated as emergencies.
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• ConditionsAnxiety DisordersGeneral information about anxiety disorders, including generalized anxiety, panic disorder and phobias: common features, evaluation and treatment overview.
• Health TopicsEmergency Warning Signs: General InformationGeneral educational information about commonly cited medical emergency warning signs, 911, Poison Help (1-800-222-1222), and the 988 Lifeline.
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