Summary

  • Chest pain may be caused by angina or a heart attack.
  • Other causes of chest pain can include indigestion, reflux, muscle strain, inflammation in the rib joints near the breastbone, and shingles.
  • If in doubt about the cause of your chest pain, call an ambulance.

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, the 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 abdomen. This is known as ‘referred pain’.

If you are in doubt about the cause of your chest pain, call 000 for an ambulance.

Chest pain – symptoms of a heart attack

Many Australians die of heart attack because they don’t know the signs or wait too long to act. New treatments for heart attack can save lives and prevent serious heart damage.

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
  • sweating
  • feeling anxious, dizzy or unwell
  • a sick feeling in the stomach
  • being short 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 has an inadequate blood supply – often when it has to work harder than usual. This can occur with exercise or high emotion, cold weather or after eating a large meal. The pain eases with rest.

Angina does not usually cause damage to the heart. The cause of the pain is reduced flow of blood to the heart due to fatty deposits (atherosclerosis) building up on the inner walls of the coronary arteries. This is also referred to as coronary artery disease. 

If the artery is blocked, a heart attack results and the heart muscle is damaged.

Cardiovascular disease risk factors

The risk factors for cardiovascular disease include: 

  • unhealthy eating
  • being overweight or obese
  • being physically inactive
  • smoking – either being a smoker or inhaling other people’s smoke (passive smoking)
  • high cholesterol
  • high blood pressure
  • diabetes
  • family history of heart disease
  • gender – males are at greater risk than females
  • age – the risk increases as we get older.

It is important to remember that people without these risk factors can also develop cardiovascular disease. 

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 muscle strains
  • inflammation in the rib joints near the breastbone (costochondritis)
  • herpes zoster virus or shingles 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, stop what you are doing. If the chest pain persists, call an ambulance to report a possible heart attack. If you have any doubt about your pain, call an ambulance anyway.

While you are waiting for the ambulance: 

  • Stop and rest quietly by sitting or lying down.
  • Chew 300 mg aspirin straight away, unless your doctor has told you not to take it.
  • Do not attempt to 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 have a lot of tests done including: 

  • electrocardiogram (ECG) – electrical tracing of the heart activity
  • blood tests – to measure markers from the heart and other organs
  • chest x-ray – to look at the lungs, heart and major blood vessels of the chest.

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).

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). 

Chest pain –taking care of yourself at home

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.
  • Even if you feel well, following up with your doctor is important. See your local doctor (GP) in the next day or two.

Reduce your risk of heart attack

Ways to reduce your risk of heart attack include: 

  • stop smoking – call Quitline for help and support
  • be physically active – enjoy moderate physical activity for 30 to 45 minutes or more on most if not all days of the week
  • eat a healthy diet – enjoy a diet low in fat and eat plenty of wholegrains, vegetables and fruit
  • watch your weight – keep a healthy weight by eating a good diet and exercising regularly
  • have regular check-ups – see your doctor for regular check-ups. Take your medication as directed. Don’t stop taking your medication unless your doctor tells you to.

Where to get help

References

More information

Heart

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Know your risks for heart disease

Heart attack warning signs and symptoms

Keep your heart healthy

Heart conditions

Content Partner

This page has been produced in consultation with and approved by: Heart Foundation

Last updated: July 2018

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