Do I need to worry about a stabbing pain in my chest?

Written by: Dr Pierluigi Costanzo
Edited by: Sophie Kennedy

Along with the discomfort brought by sudden, stabbing pains in the chest, they can be alarming for patients to experience. In this expert guide, highly respected consultant cardiologist Dr Pierluigi Costanzo explains the most common causes of pain in the chest and when to see a medical specialist.


Do I need to worry about a stabbing pain in my chest?


Sooner or later in life, we will experience pain or some sort of discomfort in our chest. So how do you know whether you need to be worried about it or not?


Here is the good news – the vast majority of the time, you don’t have to worry about it! Nevertheless, how can you know whether a chest pain is heart-related or not? And if so, whether it would need urgent attention or can wait for a bit longer.


In this article, I am going to try and reassure where I can and I advise when you need to seek medical professional help.


Let’s describe a typical scenario: you are going through the hustle and bustle of daily life. Suddenly, you feel a very localised and stabbing pain on the left side of your chest. It does not stop you from doing what you are doing, but it is there and it is causing you some concern. It might change with sitting down or standing or it might get worse or improve with a different body position. You can localise it with your finger and it might worsen if you touch the area with your finger. However, it does not get worse if you take a brisk walk, climb stairs or lift heavy weights. You have had the pain for two or three hours. Other than that, you have no other symptoms, like feeling short of breath, feeling faint or blacking out. Do you need to worry about it?


The answer is not really. This is what doctors usually refer to as “atypical chest pain”. This is a broad term to describe a symptom that is unlikely to be caused by an obstruction in the flow of the heart arteries.




What can cause atypical chest pain?


One of the most frequent causes is related to the muscles of the chest walls. In actual fact, through our life we often cause subtle trauma to the chest (i.e. lifting a heavy object, straining during exertion). Most of the time, we do not even remember when it happened but this might cause a localised chest muscle sprain, strain or bruise. As a consequence, that part of the chest will hurt. The pain will be as I have described above. These kind of pains tend to self-limit and as I explained, are in the very vast majority of times, not heart related.



What if these pains keep coming back?


There is a small chance that other forms of chest wall issues (lung diseases, rib fractures, rib joint inflammation, pinched nerve, stomach, gullet and gallbladder problems) might present this way. Occasionally, a heart related issue might present in this “atypical” way too.


A heart check-up would be certainly useful if the symptoms are persistent, especially in cases of history of high cholesterol, smoking, high blood pressure or heart diseases in the family.




Dr Costanzo is one of the UK’s leading consultant cardiologists. If you are concerned about your heart health and wish to schedule a consultation, you can do so by visiting his Top Doctors profile.

By Dr Pierluigi Costanzo

Dr Pierluigi Costanzo is an experienced consultant cardiologist practicing in Cambridge at Royal Papworth Hospital, leading heart and lung hospital in the UK, where he also serves as the clinical lead for coronary intervention. He also practices at the Nuffield Health Cambridge Hospital. Dr Costanzo has vast experience in the field of general cardiology and interventional & structural cardiology.

He has a large experience in dealing with common heart-related issues (angina or chest tightness, shortness of breath, palpitations, dizzy spells, blackouts). He also undertakes a broad range of key-hole heart interventions, including coronary (heart arteries) angioplasty and stent to relieve angina and provide improved blood flow to the heart muscle. He is a leading cardiologist also in key-hole treatments of heart valve problems (particularly for the aortic valve, for which he performs “TAVI” procedures to replace damaged aortic valves). 

Before starting his consultant post at Royal Papworth Hospital, he spent one year at Toronto General Hospital (Canada) to train in complex coronary intervention, having been awarded the competitive British Cardiovascular Intervention Society training grant. Following that, he was appointed as a structural (heart valves and structure) interventional fellow for one year at St Michael’s Hospital (Toronto, Canada). During this time he trained in  TAVI and other structural procedures, having also the opportunity to participate in several pioneering heart valve procedures.

He graduated with first-class honour and academic distinction from medical school in Italy and then moved to England where he undertook training in general internal medicine, cardiology, and interventional cardiology East Yorkshire, mainly working at Castle Hill Hospital  (Cottingham).  During this time he also obtained a Master of Science (MSc) and Doctor of Medicine (MD)
research degrees from the University of York, focusing on prevention of cardiovascular events, 
particularly in diabetic patients. He published several high-impact research articles and won multiple investigator awards at the European Society of Cardiology and American College of Cardiology conferences.

Alongside his clinical work, he holds senior positions being the audit lead for all the key-hole  (percutaneous) interventions performed at Royal Papworth Hospital. He also leads the regional teaching for the new generation of cardiologists undertaking training in angioplasty, stents, and valve interventions. He leads the research for the TAVI procedures held at Royal Papworth Hospital aimed at making this procedure as safe and effective as possible, sharing the results with the national and the international medical community. He holds an editorial position for Interventional Cardiology Review, which is a scientific journal keeping the community of specialist cardiologists up to date with the most state-of-the-art cardiac interventions.

Finally, he is a proud member of several national and international societies (i.e. British Cardiovascular Society, Canadian Cardiovascular Society, British Cardiovascular Interventional Society, European Society of Cardiology, and others).

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