Chest Pain

Chest pain is a common symptom that can have many causes, ranging from minor issues like muscle strain to life-threatening conditions like heart attack. The location, quality, and associated symptoms help determine the cause and urgency of treatment.

Not all chest pain is related to the heart, but because heart-related chest pain can be serious, it's important to understand when to seek immediate medical attention versus when it may be safe to wait and see a healthcare provider.

Chest pain can feel different depending on the cause:

Heart-related chest pain may feel like:

• Pressure, squeezing, or tightness
• Crushing or heavy sensation
• Pain that radiates to arm, neck, jaw, or back
• Accompanied by shortness of breath, nausea, sweating

Other types of chest pain may feel like:

• Sharp, stabbing pain
• Burning sensation
• Aching or dull pain
• Pain that worsens with movement or breathing
• Pain that improves with position changes

Call Emergency Services (112 in Sweden) immediately if you have:

• Severe chest pain or pressure
• Pain radiating to arm, neck, jaw, or back
• Shortness of breath
• Nausea, vomiting, or dizziness
• Sweating
• Rapid or irregular heartbeat
• Feeling of impending doom

These could indicate a heart attack or other serious condition requiring emergency treatment.

For non-emergency chest pain:

1. Rest: Stop any activity and rest
2. Monitor Symptoms: Note when pain started, what makes it better or worse
3. Avoid Triggers: If you know what causes your chest pain, avoid it
4. Over-the-counter Medications:
   • Antacids for heartburn
   • Pain relievers for muscle pain (if appropriate)
5. Relaxation: Deep breathing exercises if anxiety-related

Important: Never ignore chest pain, especially if it's new, severe, or associated with other symptoms.

• Severe chest pain or pressure
• Pain with shortness of breath
• Pain radiating to arm, neck, or jaw
• Pain with nausea, sweating, or dizziness
• Suspected heart attack or pulmonary embolism
• Any chest pain in someone with known heart disease

• Recurring chest pain
• Pain that worsens over time
• Pain with exertion
• Pain after eating
• Pain that's concerning but not severe

• Mild, brief chest pain that resolves quickly
• Pain clearly related to muscle strain
• Known cause (like heartburn) that responds to treatment

Evaluating chest pain may involve:

1. Medical History and Physical Exam:

   • Description of pain
   • Risk factors
   • Vital signs

2. Electrocardiogram (ECG/EKG):

   • Checks heart rhythm and electrical activity
   • Can detect heart attack

3. Blood Tests:

   • Cardiac enzymes (troponin)
   • Complete blood count
   • Other tests as needed

4. Chest X-ray:

   • Looks at heart, lungs, and chest structures

5. Additional Tests (if indicated):

   • Stress test
   • Echocardiogram
   • CT scan
   • Angiogram

Treatment depends on the cause:

Heart-related causes:

• Medications (aspirin, nitroglycerin, blood thinners)
• Procedures (angioplasty, stenting)
• Lifestyle changes

Other causes:

• Antacids for heartburn/GERD
• Pain medications for muscle pain
• Antibiotics for infections
• Anti-anxiety medications if anxiety-related

Prevent chest pain by:

• Heart Health:
  • Don't smoke
  • Control blood pressure and cholesterol
  • Exercise regularly
  • Maintain healthy weight
• Avoid Triggers:
  • Large meals (for heartburn)
  • Stress and anxiety
  • Overexertion
• Know Your Risk Factors: Family history, diabetes, etc.
• Regular Check-ups: Especially if at risk for heart disease

Chest pain can originate from:

Heart:

• Reduced blood flow to heart muscle (angina)
• Complete blockage (heart attack)
• Inflammation (pericarditis)

Lungs:

• Blood clot (pulmonary embolism)
• Infection (pneumonia)
• Collapsed lung (pneumothorax)

Digestive System:

• Acid reflux (heartburn/GERD)
• Esophageal spasm
• Gallbladder issues

Musculoskeletal:

• Muscle strain
• Costochondritis (inflammation of rib cartilage)
• Rib injury

Other:

• Anxiety or panic attacks
• Shingles
• Aortic dissection (tear in aorta)

• Higher risk of heart-related causes
• May have atypical symptoms
• Multiple medications may interact
• Higher risk of complications

• Most common age for heart attacks
• Stress and lifestyle factors important
• Work-related causes possible

• Rarely heart-related
• Usually musculoskeletal or anxiety
• Still requires evaluation if severe

No. Many causes of chest pain are not heart-related. However, because heart attacks are serious, any chest pain should be evaluated, especially if severe or associated with other symptoms.

Yes. Anxiety and panic attacks can cause chest pain, often described as tightness or pressure. However, it's important to rule out heart causes first.

Angina is chest pain from reduced blood flow that typically resolves with rest or medication. A heart attack involves complete blockage and permanent damage to heart muscle.

Only if recommended by a healthcare provider or emergency services. Aspirin can help in heart attacks but may not be appropriate for all causes of chest pain.

Yes, sometimes heartburn can feel similar to heart-related chest pain. If you're unsure, seek medical evaluation to rule out serious causes.