Decoding chest pain: A cardiologist’s guide to understanding symptoms
Chest pain is a symptom that does not always indicate a serious heart problem.
In this article, consultant cardiologist Dr Abdullah Mohammed outlines the various causes of chest pain, how to recognise when it may be serious, and what steps you can take to protect your heart health.
Understanding chest pain
Chest pain can arise from many different sources, not just the heart. It is important to understand the context, type of pain, and associated symptoms to identify its cause. Broadly, chest pain can be classified into cardiac and non-cardiac origins.
Cardiac chest pain
Cardiac chest pain originates from the heart and is often the most serious type, so it is important to recognise the signs early.
Angina
Angina occurs when the heart does not get enough blood flow, usually due to narrowed coronary arteries. It is typically described as a pressure, tightness, or squeezing sensation in the chest, often triggered by physical activity or stress and relieved by rest.
Heart attack
A heart attack (myocardial infarction) is a medical emergency. Pain may feel similar to angina but is more intense, persistent, and can radiate to the arm, jaw, neck, or back. Accompanying symptoms often include shortness of breath, sweating, nausea, or dizziness.
Other cardiac causes
Less common cardiac causes of chest pain include pericarditis (inflammation of the heart lining) and cardiomyopathy. These conditions often present with additional symptoms, such as fever or palpitations.
Non-cardiac chest pain
Not all chest pain originates from the heart. Common non-cardiac causes include:
Gastrointestinal causes
Acid reflux or heartburn can cause a burning sensation in the chest. Unlike cardiac pain, it often worsens after eating or when lying down.
Musculoskeletal causes
Strain or injury to the chest muscles or ribs can cause sharp, localised pain, often triggered by movement or touch.
Respiratory causes
Conditions like pneumonia, pleuritis, or pulmonary embolism can lead to chest discomfort, often accompanied by cough, shortness of breath, or fever.
Anxiety and stress
Chest tightness or discomfort can also be linked to anxiety or panic attacks. These episodes are usually associated with rapid heartbeat, shortness of breath, and a sense of fear or dread.
When to seek medical help
It is important to recognise when chest pain requires urgent attention. Seek immediate help if you experience:
- Severe or persistent chest pain.
- Pain radiating to the arm, jaw, or back.
- Shortness of breath, sweating, nausea, or dizziness.
- Chest pain following physical exertion or emotional stress.
Even if symptoms are mild or intermittent, it is advised to consult a healthcare professional to rule out serious conditions.
Chest pain can stem from a variety of causes, ranging from minor issues to life-threatening emergencies. Understanding the type of pain, associated symptoms, and triggers can help guide when to seek urgent care.