Chest Pain

What You Need to Know

Chest pain can be alarming, and for good reason. While not all chest pain is linked to heart disease, it remains one of the most common symptoms prompting urgent medical attention. As someone who regularly works with patients experiencing chest discomfort, I understand how unsettling it can be—not knowing whether it’s something minor or a sign of a serious condition.

I’ll explain the different causes of chest pain, how to recognise when it might be heart-related, and when to seek medical help.

What Causes Chest Pain?

Chest pain is not always caused by a heart condition. There are several possible reasons for discomfort in the chest, ranging from muscular strain to digestive issues. However, because some causes can be life-threatening, it is important to understand the differences.

Here are some of the most common causes of chest pain:

1. Heart-Related Causes

If chest pain is due to a heart condition, it is often referred to as cardiac chest pain. The most common heart-related causes include:

Angina

Angina occurs when blood flow to the heart is temporarily reduced due to narrowed coronary arteries.

• Symptoms include tightness, pressure, or burning in the chest, often triggered by exertion or stress and relieved by rest.

• This is a warning sign of underlying coronary artery disease and should not be ignored.

Heart Attack (Myocardial Infarction)

A heart attack occurs when a coronary artery is completely blocked, preventing blood flow to part of the heart muscle.

• Symptoms include intense chest pain or pressure that lasts more than a few minutes, often radiating to the arms, jaw, or back. Sweating, nausea, and shortness of breath may also occur.

• This is a medical emergency. Immediate medical attention is required.

Aortic Dissection

A rare but life-threatening condition where the inner layer of the aorta (the main artery leaving the heart) tears.

• Symptoms include sudden, severe chest pain that may feel like tearing or ripping in the chest or back.

• This requires emergency treatment as it can be fatal if not managed quickly.

Pericarditis

Inflammation of the pericardium, the sac surrounding the heart.

• Symptoms include sharp chest pain that worsens with deep breathing or lying flat but improves when sitting up.

• Though not always life-threatening, persistent symptoms should be assessed by a doctor.

2. Lung-Related Causes

Chest pain can also originate from the lungs and respiratory system. Some of the most common causes include:

Pulmonary Embolism (PE)

A blood clot in the lungs that can cause sudden chest pain, shortness of breath, and rapid heart rate.

• This is a medical emergency requiring immediate care.

Pneumonia

An infection in the lungs that can cause sharp or stabbing chest pain, often worsened by breathing or coughing.

• Severe pneumonia may require antibiotics or hospital care.

Pneumothorax (Collapsed Lung)

Occurs when air leaks into the space around the lung, causing it to collapse.

• Symptoms include sudden, sharp chest pain and difficulty breathing.

• Large pneumothoraxes require emergency treatment.

3. Digestive Causes

Chest pain is not always heart-related—it can sometimes stem from the digestive system, including:

Gastroesophageal Reflux Disease (GORD)

Also known as acid reflux, this occurs when stomach acid irritates the oesophagus.

• Symptoms include burning chest pain (heartburn), often after eating or when lying down.

• While not life-threatening, untreated reflux can lead to complications.

Gallbladder Disease

Gallstones or inflammation of the gallbladder can cause upper abdominal pain that may feel like chest pain.

• Pain often occurs after eating, particularly after fatty meals.

4. Musculoskeletal Causes

Chest pain can also originate from the muscles, bones, or nerves, particularly after injury or strain.

Costochondritis

Inflammation of the cartilage connecting the ribs to the breastbone.

• Symptoms include sharp chest pain, particularly when pressing on the chest.

• Though harmless, it can be mistaken for heart-related pain.

Muscle Strain

Overuse or injury can cause muscle pain in the chest wall.

• Symptoms worsen with movement or touch.

When Should You Seek Medical Help?

It can sometimes be difficult to tell whether chest pain is serious. While not every case requires emergency treatment, you should seek immediate medical attention if you experience:

• Severe chest pain that lasts more than a few minutes.

• Pain spreading to the arms, jaw, back, or neck.

• Shortness of breath or difficulty breathing.

• Dizziness, fainting, or nausea.

• Chest tightness or pressure that worsens with exertion.

If you suspect a heart attack, seek emergency medical care immediately. It is always better to get checked and be safe.

How Is Chest Pain Diagnosed?

Your doctor may use a combination of tests to determine the cause of your chest pain, including:

• ECG (Electrocardiogram) – Measures the heart’s electrical activity.

• Blood Tests – Looks for markers of heart damage (e.g., troponin for heart attacks).

• Echocardiogram – An ultrasound of the heart to check structure and function.

• Chest X-ray – Helps detect lung-related issues like pneumonia or pneumothorax.

• CT Scan – Provides detailed imaging for diagnosing aortic dissections or pulmonary embolisms.

Treatment will depend on the cause of your chest pain, ranging from lifestyle changes and medication to emergency interventions if required.

How to Reduce Your Risk of Heart-Related Chest Pain

Many cases of heart-related chest pain can be prevented with healthy lifestyle choices:

• Eat a heart-healthy diet with reduced processed foods, saturated fats, and salt.

• Exercise regularly, aiming for at least 150 minutes of moderate activity per week.

• Manage stress levels, as chronic stress contributes to heart disease.

• Quit smoking, as it damages the arteries and increases heart disease risk.

• Monitor blood pressure and cholesterol through regular check-ups.

For more tips on heart health, visit the NHS heart health guide.

Conclusion

Chest pain can stem from many causes, ranging from minor muscle strain to serious heart disease. While some types of chest pain are harmless, others require immediate medical attention. Knowing the symptoms and seeking timely care can make all the difference.

If you are experiencing chest pain and need a thorough evaluation, contact us here to book an appointment with one of our cardiology specialists. You can also book an appointment using our online tool here At Heartsure, we offer expert assessments to ensure your heart is in good health, using the google link on the Heartsure word, you can see some reviews from past patients!