Chest pain can be serious. It may be caused by temporary poor blood flow to the heart (angina), or by a sudden blockage in the coronary arteries resulting in a heart attack.
If you have chest pain, seek urgent medical help. Call 000 for an ambulance.
There are other possible causes of chest pain such as indigestion and muscle strain. Aside from the heart, many parts of the chest that can cause chest pain include the lungs, oesophagus (gullet), muscle, bone and skin.
Because of the complex system of nerves in the body, the cause of the chest pain may come from elsewhere in your body, such as your stomach (abdomen). This is known as ‘referred pain’.
In a heart attack, every minute counts. Urgent treatment is needed to prevent damage to the heart.
If you think you are having a heart attack, or you are in doubt about the cause of your chest pain, call 000 for an ambulance.
Chest pain – symptoms of a heart attack
Chest pain can be a warning sign of a heart attack. A heart attack happens when the blood supply to your heart becomes blocked and damages the heart muscle.
The longer a heart attack is left untreated more damage occurs. In some cases, a heart attack can be fatal. Many Australians die of heart attack, or suffer permanent damage to the heart because they don’t know the signs or wait too long to act.
Symptoms of a heart attack may include:
- Severe crushing pain in the centre of your chest or behind the breastbone. You may feel this as a squeezing, tightening, choking or heavy pressure feeling.
- Pain spreading to the shoulders, arms, neck, throat, jaw or back.
- Feeling anxious, dizzy or unwell.
- A sick feeling in the stomach.
- Shortness of breath.
- Symptoms that often last 10 to 15 minutes or more.
Symptoms of a heart attack may vary from person to person, and some people have few symptoms or none at all.
Chest pain – angina
Angina is a short-lived chest pain that occurs when the heart muscle does not receive enough blood or oxygen – often when it has to work harder than usual. This can occur with exercise, stress, cold weather or after eating a large meal.
Angina pain eases with rest, or with the use of angina medicines.
Angina is usually caused by underlying coronary artery disease, where the arteries of the heart become narrow due to the buildup of plaque (fatty deposits) in the artery walls. This narrowing means that blood supply to the heart is reduced, causing chest pain (angina). Angina does not usually cause damage to the heart.
Angina and heart attack – risk factors
Angina and heart attack are usually caused by underlying coronary artery disease, which has certain risk factors – some you can change, others you can’t.
Risk factors you can change:
Risk factors you can’t change:
- getting older – risk increases as we age
- being a post-menopausal woman
- being male
- family history of heart disease
- ethnicity – Aboriginal Torres Strait Islander and certain other populations are at higher risk
It is important to remember that people without these risk factors can also experience angina or a heart attack.
Other common causes of chest pain
The symptoms of a heart attack are similar to other conditions, so your chest pain may have nothing to do with your heart.
Other common causes of chest pain include:
- Indigestion or stomach acid coming up the oesophagus (reflux). This common problem can be made worse by smoking, drinking alcohol or coffee, eating fatty foods and taking some drugs. You may feel this as a burning pain in the chest. It often goes away quickly after taking antacid or milk.
- Chest infection.
- Chest trauma (rib fractures).
- Blood clots in your lungs (pulmonary embolism).
- Chest muscle strains – these can be caused by vigorous exercise, physically active work, playing contact sport or lifting weights at the gym.
- Inflammation in the rib joints near the breastbone (costochondritis).
- Shingles (or herpes zoster) or can cause chest pain before a rash forms.
Seek urgent medical help for chest pain
With chest pain, every minute counts. The faster you get to hospital for treatment, the better.
If any activity brings on chest pain, follow these steps:
1. Stop what you are doing and rest immediately.
2. Talk – tell someone how you feel.
If you take angina medication:
- Wait 5 minutes. If you still have symptoms – take another dose of your medicine.
- Wait 5 minutes. If your symptoms don’t go away…
3. Call 000 and chew on 300mg aspirin (if available).
- Ask for an ambulance.
- Don’t hang up.
- Wait for the operator’s instructions.
Do not take aspirin if you have an allergy to aspirin, or your doctor has told you not to take it.
Remember, if you have any doubt about your pain, call an ambulance anyway.
Do not drive yourself to hospital. Wait for the ambulance. It has specialised staff and equipment that may save your life.
Diagnosis of chest pain
Before medical treatment can begin, the cause of the pain must be found. You may a have a lot of tests done including:
If your healthcare professional thinks you may have angina, they may order further tests to check the state of the blood vessels that supply your heart. They may also arrange an exercise stress test (on an exercise bike or treadmill) or other tests – such as an angiogram or CT scan of your chest.
It is not always easy to diagnose the cause of chest pain. Your doctor may need to see you more than once to be sure, and further tests may be needed, or you may be referred to a cardiologist (heart doctor).
Recovering from chest pain
If your doctor has ruled out serious causes of chest pain, it is likely you will make a full recovery. General self-care suggestions include:
- Follow your doctor’s advice about treatment.
- In the first few days at home, try to take it easy.
- Rest if you feel tired.
- Slowly increase your activity, as you are able.
- There is no need to limit work or strenuous activity (including sex) if you feel well.
- Follow up with your local doctor (GP) when recommended by your treating doctor.
Reduce your risk of heart attack
Ways to reduce your risk of heart attack include:
Where to get help
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