Chest Pain: Causes, Symptoms & When to Seek Urgent Care

Chest pain can be frightening, especially when it comes on suddenly or feels unfamiliar. A tight, sharp, or heavy sensation in your chest can immediately make you worry about your heart, even if you are not sure what is causing it.

The reality is that chest pain can have many causes. Some are minor, such as muscle strain, indigestion, or stress, while others do need prompt medical attention. Understanding the different types of chest pain, recognising warning signs, and knowing when to seek medical care can help you respond calmly and protect your health.

What is chest pain?

Chest pain refers to any pain or discomfort that occurs in the chest area, located between your neck and your upper abdomen. While often associated with the heart (cardiac chest pain), this symptom can originate from other areas such as your lungs, muscles, ribs, or digestive system. 

You may experience:

• A dull, aching, heavy sensation in the centre of your chest

• Sharp, stabbing pain that worsens when taking a breath

• A burning feeling rising from the stomach to the throat

• A crushing pressure or "squeezing" tightness

• Tenderness when pushing on the chest wall

Chest pain does not always feel severe, even when the cause is serious. For that reason, it is important to listen to what your body is telling you, not just how strong the pain feels. Paying attention to the type of discomfort, how it starts, and any other symptoms can help you know when to seek medical attention and get timely treatment. 

What are the types of chest pain?

Because many different conditions can cause chest pain, recognising the subtle differences between heart-related pain and other types can help you understand when symptoms may be more serious.

Heart-related conditions do not always follow typical patterns, as symptoms can be less obvious in women, older adults, and people with diabetes. 

If you are unsure, or if the pain is sudden, severe, or worsening, it is always safest to seek emergency medical care so that serious conditions can be identified early and treated without delay.

What are the causes of chest pain?

Many different factors can cause discomfort in your chest. While it is natural to worry about serious problems, chest pain can range from temporary, everyday causes to medical emergencies involving the heart or lungs. 

Understanding the possible causes can help you recognise when to seek urgent care.

Heart-related causes

Cardiac chest pain usually signals a more serious problem and often requires immediate medical attention.

• Acute coronary syndrome (ACS):

  • Occurs when a blood clot reduces or blocks blood flow to your heart, cutting off oxygen to the heart muscle.

  • Can cause unstable angina (sudden or worsening chest pain) or myocardial infarction (heart attack).

• Coronary artery disease (CAD):

  • Occurs when fatty plaque (a buildup of fats, cholesterol and other substances in your heart arteries) develops in your heart’s blood vessels.

  • Can cause chest pain (angina) during activities like fast walking, climbing stairs, or exercise.

  • In some cases, it can suddenly worsen and lead to a heart emergency.

• Aortic dissection:

  • A serious condition where the inner layer of your aorta, the main artery carrying blood from the heart, tears and disrupts normal blood flow.

  • Causes sudden, severe chest pain that may feel tearing and spread to your back.

• Pericarditis:

  • Occurs when the lining around your heart becomes inflamed.

  • Can cause sharp chest pain that feels worse when you take a deep breath or lie flat.

Cardiac chest pain should never be ignored. It is understandable to feel frightened if you experience it, but if you notice sudden, severe, or persistent chest pain, seeking emergency medical care straight away is the safest step you can take. 

Early assessment does not mean the worst is happening, but it can be life-saving and helps ensure you receive the right care as quickly as possible.

Lung-related causes

Chest pain can also come from the lungs, especially when breathing becomes uncomfortable or difficult. These conditions may cause pain that feels sharp or worsens when you take a deep breath, cough, or move, and they often need medical attention.

• Pulmonary embolism:

  • This happens when a blood clot blocks an artery in your lungs.

  • You may suddenly feel short of breath, with sharp chest pain that can come on without warning.

  • Can make you feel anxious, lightheaded, or unwell very quickly.

• Pulmonary hypertension:

  • Occurs when blood pressure in the arteries of your lungs is higher than normal, causing your heart to work harder to pump blood. 

  • Over time, this can lead to chest discomfort, breathlessness, and fatigue.

• Respiratory infections:

  • Infections such as pneumonia can irritate your lungs and airways.

  • Causes chest tightness or pain, especially when you breathe deeply or cough.

If you experience chest pain along with sudden breathlessness or worsening discomfort, it is natural to feel concerned. Seeking medical care promptly is the safest step and does not mean you are overreacting. 

Getting checked early can help rule out serious lung conditions and ensure you receive the right care at the right time.

Digestive and muscle-related causes

Chest pain does not always come from the heart or lungs. Sometimes, it can be linked to digestion, muscles, or nerves around the chest. These causes are often less serious, but they can still feel uncomfortable and worrying when they happen. 

• Acid reflux or gastro-oesophageal reflux disease (GERD):

  • Happens when stomach acid flows back into your oesophagus.

  • Can cause a burning sensation in your chest, often called heartburn.

  • May feel worse after eating, lying down, or bending over.

• Muscle strain or costochondritis:

  • Occurs when the muscles or joints between your ribs and breastbone become inflamed.

  • Often follows exercise, heavy lifting, or a minor injury.

  • Pain usually worsens with movement or when you press on the area.

• Nerve pain:

  • Can occur when nerves in the chest wall become irritated, such as with shingles.

  • May cause burning or band-like pain that wraps around one side of the chest.

  • Pain can appear before a skin rash develops.

Although these causes are usually less serious, chest pain can still feel frightening and hard to ignore. 

Understanding what may be behind your symptoms helps you make sense of what your body is telling you, rather than being left to imagine the worst. This clarity can help you feel more confident about when and where to seek the right care.

What should you do if you have chest pain?

If you notice sudden chest pain, it is important to stay calm and follow these practical steps to assess the situation:

• Immediately stop any physical activity and sit or lie down in a comfortable position

• Ensure your clothes are not restricting your breathing

• Check for cold sweats, dizziness, or difficulty breathing

• If you have been prescribed nitroglycerin for CAD, take it as directed

• Check your blood pressure if you have a home monitor

These steps can help steady your body and give you a moment to feel more settled while you decide what to do next. 

If the pain continues, it is important not to carry the worry on your own or wait too long. Your doctor can help explain what is happening, rule out anything serious early, and gently guide you towards the most appropriate next steps.

What are the treatment options?

Chest pain is not treated the same way for everyone. The right treatment depends on what is causing your symptoms. 

Your doctor will focus on analysing the causes to rule out serious conditions such as a heart attack or pulmonary embolism. From there, your care is guided by what your body needs.

Diagnostic tests

To understand what may be happening, your doctor may recommend imaging tests and scans that help clarify the cause of your chest pain, including:

• Electrocardiogram (ECG) to check your heart’s electrical activity and look for rhythm changes or signs of strain

• Blood tests to identify markers that suggest heart muscle damage or inflammation

• Chest X-ray to examine your lungs and assess the size and shape of your heart

• CT scans to have detailed images of your blood vessels and look for blockages, clots, or conditions such as aortic dissection

These tests help your doctor figure out what is causing your chest pain and check whether your heart, lungs, or blood vessels may be involved. Based on the results, your care team can decide if you need urgent treatment, closer follow-up, or reassurance that nothing serious has been found.

Medications and professional care

Once the cause of your chest pain is clearer, your care team will work closely with you to create a treatment plan tailored to your needs.

• Clot-dissolving medications, used in emergencies to restore blood flow during a heart attack or pulmonary embolism

• Blood thinners to help prevent clots from forming and improve circulation

• Acid-suppressing medications to reduce stomach acid if chest pain is linked to acid reflux or GERD

• Pain relief and supportive care to ease discomfort from muscle strain, inflammation, or nerve-related pain

Your doctor will carefully choose the treatment options to address the cause of your symptoms while improving discomfort and supporting your recovery. With the right care in place, you can begin to feel more comfortable and confident as the symptoms improve.

Hospital treatment

In more serious cases, especially those involving CAD, you may need to receive further treatment in hospital.

• Angioplasty, which opens narrowed or blocked arteries to restore blood flow to the heart

• Coronary artery bypass surgery (CABG) to redirect blood flow around blocked arteries when multiple vessels are affected

• Monitoring and stabilisation to help manage blood pressure, heart rhythm, and overall stability

If these treatments sound complex or overwhelming, it is completely understandable to feel that way. They are carefully chosen to protect your heart and support its healing, both now and in the long term. 

Can chest pain be prevented?

While you cannot always prevent chest pain, you can significantly reduce your risk of cardiovascular disease, one of the main and most serious causes of chest pain, by making small, consistent lifestyle changes.

• Have a heart-healthy diet and focus on whole foods to manage cholesterol and blood pressure

• Stay active and do regular exercise to strengthen your heart

• Find time to relax and recharge

• Quit smoking

• Attend routine health check-ups if your family members have heart issues

By caring for your body and staying aware of your personal risk, you give yourself the best chance to protect your heart and maintain long-term health. If you are unsure where to start, a healthcare professional can help guide you with advice that suits your lifestyle and needs.

When should you seek medical urgency?

Chest pain is a symptom that you should never ignore. 

Seek urgent medical care immediately if:

• You feel a crushing pressure or squeezing that lasts more than a few minutes

• The pain radiates to your jaw, neck, or left arm

• You experience sudden shortness of breath or cannot breathe while lying flat

• You feel incredibly weak, have cold sweats, or feel like you might faint

• You have a known history of heart conditions such as hypertrophic cardiomyopathy or heart attack

For a family member or loved one, act immediately if they collapse and do not respond. Call an ambulance right away and begin cardiopulmonary resuscitation (CPR) if you are trained. Quick action can save a life.

FAQ

Is chest pain always a heart attack? 

No. Many cases are non-cardiac, such as muscle strain or acid reflux. However, because cardiac chest pain, including heart attack, is potentially life-threatening, you should get checked immediately if unsure. 

What is coronary microvascular disease? 

This is a heart disease that affects the tiny coronary arteries. It can cause chest pain even if the main arteries are not blocked and is often detected via specialised testing like cardiac MRI.

Can acid reflux feel like a heart attack? 

Yes. Gastro-oesophageal reflux disease (GORD), or acid reflux–related gastritis, can cause intense, burning chest pain that may feel similar to heart-related pain. If the discomfort improves after taking antacids, the cause may be digestive. However, antacids should not be taken without medical advice. 

Does high blood pressure cause chest pain? 

High blood pressure itself is often a "silent killer" with no symptoms, but over time it damages arteries, leading to coronary artery disease or pulmonary hypertension, which can cause chest pain.

What if the pain is from a sports injury? 

Sports injuries often result in muscle strain or rib inflammation. This pain usually worsens when you move your torso or press on the area, unlike heart pain, which is internal.

Is it normal for chest pain to come and go?

Chest pain can come and go, especially with conditions like acid reflux or angina. Even if it settles on its own, it is still important to have it checked, particularly if it keeps returning.

The information is intended for general guidance only and should not be considered medical advice. For personalised recommendations and advice based on your unique situation, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.