Chest
Chest pain
Discomfort, pressure, tightness or sharp pain anywhere in the chest that can come from the heart, the food pipe and stomach, the lungs, the muscles and ribs, or from anxiety — and which occasionally signals a life-threatening emergency such as a heart attack.
Education and reference only. This explains the common causes of chest pain and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is chest pain?
Chest pain is one of the most worrying symptoms a person can have, because while many causes are harmless the chest also houses the heart and major blood vessels. The character of the pain offers clues but is never reliable enough to rule danger out on its own: a heavy, crushing or tight pressure across the centre of the chest — especially with breathlessness, sweating, nausea or pain spreading to the arm, jaw or back — points towards the heart, whereas a sharp pain that is worse on breathing in or on certain movements more often comes from the lung lining, the muscles or the ribs.
- Get urgent help: Call 999 now if you have central chest pain or tightness that lasts more than about 15 minutes, especially with sweating, nausea or breathlessness — this may be a heart attack. Call 999 if the pain spreads to your arm, jaw, neck or back, or if you feel faint, clammy or grey.
- Self-care: If a doctor has already explained that your chest pain comes from a non-urgent cause such as reflux or muscle strain, you can ease it with simple measures: rest a strained chest wall and avoid the movements that aggravate it, sit upright after meals and avoid eating late at night if reflux is the cause, cut back on alcohol and caffeine, and try slow, steady breathing if stress or anxiety is a trigger.
About chest pain
Chest pain is one of the most worrying symptoms a person can have, because while many causes are harmless the chest also houses the heart and major blood vessels. The character of the pain offers clues but is never reliable enough to rule danger out on its own: a heavy, crushing or tight pressure across the centre of the chest — especially with breathlessness, sweating, nausea or pain spreading to the arm, jaw or back — points towards the heart, whereas a sharp pain that is worse on breathing in or on certain movements more often comes from the lung lining, the muscles or the ribs. A burning pain that rises behind the breastbone after meals or when lying down usually comes from acid reflux. Because the consequences of missing a heart attack are so serious, sudden, severe or unexplained chest pain should always be treated as an emergency until proven otherwise.
When to get help
Call 999 or go to A&E if chest pain comes with any of these warning signs:
- Call 999 now if you have central chest pain or tightness that lasts more than about 15 minutes, especially with sweating, nausea or breathlessness — this may be a heart attack.
- Call 999 if the pain spreads to your arm, jaw, neck or back, or if you feel faint, clammy or grey.
- Call 999 for sudden, severe, tearing chest or back pain — this can signal a tear in a major blood vessel.
- Call 999 if chest pain comes with sudden severe breathlessness or coughing up blood, which can mean a clot on the lung.
- Seek urgent help if pain is brought on by less and less exertion, or now comes on at rest, when you have known angina.
When to see a doctor
Treat new, severe or unexplained chest pain as an emergency and call 999 — do not drive yourself to hospital. If you have known angina and your usual pain is more frequent, more severe or no longer settles with rest, that also needs urgent assessment. For milder, recurring chest discomfort with no emergency features — such as burning after meals or a localised ache that moves with position — book a routine appointment so the cause can be confirmed, but seek help sooner if anything changes.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of chest pain
Chest pain has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
If a doctor has already explained that your chest pain comes from a non-urgent cause such as reflux or muscle strain, you can ease it with simple measures: rest a strained chest wall and avoid the movements that aggravate it, sit upright after meals and avoid eating late at night if reflux is the cause, cut back on alcohol and caffeine, and try slow, steady breathing if stress or anxiety is a trigger. Keep a note of what brings the pain on and what relieves it, as this helps your clinician. None of this replaces assessment — only use self-care for pain that has already been investigated and found not to be dangerous.
Answers
Chest pain: frequently asked questions
Does chest pain always mean a heart problem?
No. Many cases come from acid reflux, the muscles and ribs, or anxiety. But because a heart attack is so serious, sudden, severe or central chest pain should always be checked urgently rather than assumed to be harmless.
How can I tell heart pain from reflux?
You often cannot reliably. Reflux tends to burn behind the breastbone after meals or when lying down, while heart pain is often a heavy central pressure brought on by exertion. Any uncertainty about chest pain should be treated as an emergency.
Can stress and anxiety really cause chest pain?
Yes. Anxiety and panic can cause genuine chest tightness, a racing heart and breathlessness. However, this should only be accepted as the cause once a clinician has ruled out the heart and lungs.
What should I do while waiting for an ambulance for chest pain?
Stop what you are doing, sit down and rest, and stay calm. Unlock your door if you can. If you have been prescribed a heart spray or tablets for angina, use them as your clinician advised while you wait for help.
Sources
Where this is drawn from
- NICE CKS: Chest pain.
- British Heart Foundation: heart attack warning signs.
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