Heart and Vascular Center

Chest Pain

Chest discomfort or pain is a key warning symptom of a heart attack. This sort of pain produces chest discomfort or pain that is crushing, squeezing, or feels like a heavy weight on the chest.

It also includes discomfort or pain that occurs with symptoms such as:

  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Dizziness or lightheadedness.
  • Pain that spreads from the chest to the back, neck, jaw, upper abdomen, or one or both shoulders or arms.
  • Fast, slow, or irregular heartbeat.

If you have any of these symptoms of a heart attack, call 911 or other emergency services immediately. Most of the damage to the heart muscle during a heart attack occurs in the first 6 hours; immediate emergency treatment may prevent damage to the heart muscle and death.

Chest discomfort or pain that comes on or gets worse with exercise, stress, or eating a large meal and then goes away with rest may be a warning sign of heart disease. This type of pain may be a heart attack or angina. If you are having this type of discomfort or pain now and you are not being treated for angina, call 911 or other emergency services immediately.

Most people fear that chest pain always means something is wrong with the heart. Fortunately, this is not the case. Chest discomfort or pain has many other causes.

The cause of chest discomfort or pain can be hard to determine. The more you know about your symptoms, the easier it will be for you to decide what you need to do next.

Here are some things to think about when you or someone you know has chest pain:

  • Have you had an injury to the chest?
  • What causes chest pain and what makes it better or worse?
  • How does the chest pain feel and how long does the pain last?
  • How severe is your pain?
  • Does the pain seem to spread to or from other areas of the body?
  • Do you have chest pain with other symptoms?

The causes of chest pain

The cause of chest pain can be hard to determine. The more you know about your symptoms, the easier it will be for you to decide what you need to do next. If you do not have symptoms of a heart attack, here are some things to consider when you have chest pain.

What brings on the chest pain or makes it better or worse?

  • Pain, pressure, heaviness, or tightness across the chest or numbness in the shoulders or arms (especially on the left side) may be caused by angina. Angina is a sign that your heart is temporarily not getting enough blood flow or enough oxygen. Angina is brought on by activities that make the heart work harder and is often relieved by rest and medications.
  • Pain that starts with an activity may get better with rest from the activity. Pain that gets worse with more activity or from moving a certain way may be caused by inflammation of cartilage in the chest wall (costochondritis). Twisting movements can cause costochondritis. Certain lifting movements of the arms (thoracic outlet syndrome) can cause chest pain.
  • Pain that gets worse when you press your finger on the area or when you breathe deeply, cough, or sneeze may be caused by chest wall pain.
  • Pain that gets worse with deep breaths, coughing, or sneezing also may be caused by a problem in or around the lungs, such as an infection in the lung (pneumonia), inflammation of the lining of the lung (pleurisy), a collapsed lung (pneumothorax), a blood clot in the lung (pulmonary embolus), or severe asthma.
  • Pain that is made better or worse by eating may be caused by an intestinal problem, such as an ulcer, gallbladder disease or gallstones, heartburn, a hiatal hernia, or inflammation of the stomach (gastritis) or by esophageal problems.
  • Chest discomfort that starts after fast, deep breathing may be caused by hyperventilation. Stress might cause a person to hyperventilate. Panic attacks can cause feelings of hyperventilation and chest pain.

Have you had an injury to the chest?

An injury to the chest can cause mild to severe pain. Pain may be caused by an injury to muscles, cartilage, or ribs. This pain can occur with movement of a shoulder, an arm, the rib cage, or the trunk of the body. Deep breathing, coughing, or sneezing also can increase the pain. Other common symptoms are pain with direct pressure on the area or pain when lying on the injured area. Even a minor injury can cause chest pain for days after the injury.

Pain or difficulty in breathing that starts immediately after a severe injury may mean that organs inside the chest, such as the lungs, heart, or blood vessels, have been damaged. Often other symptoms, such as true shortness of breath or shock, develop quickly.

Even after a chest injury, it is important to determine whether your pain might be caused by a heart problem. If you do not have any symptoms of a heart attack, it is probably your chest injury that is causing your pain.

Another heart problem that may cause pain or discomfort is angina. Symptoms of angina include pain, pressure, heaviness, tightness, or numbness most commonly felt behind the breastbone (sternum) or across the chest. Angina could be related to a chest injury, though it is more commonly brought on with activity, in which case it decreases with rest and increases with more activity.