Chest pain

Call for an ambulance immediately if you develop sudden severe chest pain. This is particularly important if the chest pain:

• feels heavy, pressing or tight
• lasts longer than 15 minutes
• spreads to other parts of your body – such as your arms, back or jaw
• is alongside other symptoms – such as breathlessness , nausea, sweating, or coughing up blood

You should also be cautious if you know you're at risk of

If your chest pain is only minor or has resolved itself quickly, it may be more appropriate to either:

• see your doctor
• attend a local walk-in centre

Chest pain and heart problems

Chest pain isn't always caused by a problem with your heart, but it can sometimes be a symptom of:

• angina
  – where the blood supply to the muscles of the heart is restricted
• a heart attack
  – where the blood supply to part of the heart is suddenly blocked

The main differences between these conditions is that chest pain caused by angina tends to be triggered by physical activity or emotional stress, and gets better with rest after a few minutes.

Symptoms of a heart attack tend to last more than 15 minutes, occur at rest, and include sweating and vomiting.

If you've previously been diagnosed with angina, the pain may be relieved by your angina medication. A second dose can be taken after five minutes if the first dose is not effective.

Call for an ambulance if:

• you're experiencing symptoms of a heart attack
• you have angina and your medication still isn't effective five minutes after a second dose

Common causes of chest pain

Most chest pain is not heart-related and isn't a sign of a life-threatening problem.

This information should give you an idea of whether these conditions may be causing your chest pain, but you should always seek medical advice to make sure you get a proper diagnosis.

Some common causes of chest pain include:

• gastro-oesophageal reflux disease (GORD)
  – a common condition where acid from the stomach comes up into the oesophagus (gullet), causing heartburn and an unpleasant taste
• a strained muscle in your chest wall – which can be surprisingly painful, but with rest the pain should ease and the muscle will heal in time
• costochondritis
  – inflammation of the cartilage that joins the ribs to the breastbone; symptoms include pain, swelling and tenderness around your ribs, and the pain is made worse by lying down, breathing deeply, coughing or sneezing
• an anxiety or panic attack – which tends to last up to 20 minutes and may also cause symptoms such as heart palpitations , sweating, breathlessness and dizziness
• lung conditions such as
  pneumonia
  or
  pleurisy
  – which often cause sharp chest pain that gets worse when you breathe in and out, and are accompanied by other symptoms such as a cough and breathlessness

Other possible causes of chest pain

There are many other potential causes of chest pain, including:

• shingles
  – a viral infection of a nerve and the area of skin around it, which causes a painful rash that develops into itchy blisters
• mastitis
  – pain and swelling of the breast, which is usually caused by an infection, most commonly during breastfeeding
• acute cholecystitis
  – inflammation of the gallbladder, which can cause a sudden sharp pain in the upper right side of your tummy that spreads towards your right shoulder
• stomach ulcers
  – a break in the lining of the stomach, which can cause a burning or gnawing pain in your tummy
• a pulmonary embolism
  – a blockage in the blood vessel that carries blood from the heart to the lungs, which can cause sharp, stabbing chest pain that may be worse when you breathe in, as well as breathlessness, a cough and dizziness
• pericarditis
  – inflammation of the sac surrounding your heart, which can cause a sudden, sharp and stabbing pain in your chest, or more of a dull ache; the pain usually worsens when lying down

Some of these conditions can be very serious. Make sure you seek medical advice so you can be correctly diagnosed and treated.