When is chest pain serious?

Written by: Dr Amarjit Sethi
Edited by: Laura Burgess

Cardiac chest pain, or the pain of a heart attack, has been described as a sudden onset of pain in the centre of the chest that feels like a heaviness, pressure or weight on the area. It has also been described as a tight band or like a tight belt around the chest as in some adverts. It may radiate or spread to other areas like the arms or neck and jaw and may be associated with other symptoms or feelings. These may include the sudden onset of shortness of breath, sweating or being sick. These feelings could represent a heart attack and the advice would be to call 999 immediately for an ambulance.

What are the most common causes of chest pain unrelated to the heart? 

Other common causes of chest discomfort or pain are indigestion or heartburn, muscular problems after a strain which are relieved by resting the muscle, chest infections or other infections like shingles affecting the chest wall with an associated rash.


What are the most common heart problems that cause chest pain?

Angina causes chest pain due to the narrowing of the arteries in the heart. This feels like pain in the centre of the chest on exertion and is relieved by rest or the use of a nitrate spray or tablet. Nitrate is used by cardiologists to enable the heart to work more easily. Once in use, the nitrate converts to a natural chemical in the body, nitric oxide. This enables the arteries and veins to relax and widen, which makes it easier for the heart to pump blood around the body.

 Angina may be short-lived but can last longer and feel like the description of a heart attack above. A heart attack is due to a blockage of an artery in the heart and is life-threatening needing urgent medical treatment to unblock the artery. This is called angioplasty and is performed in specialist heart attack centres.


When should I see a specialist?

If you have chest pain on exertion that disappears quickly or you are worried about the recent onset of chest pain, even if it comes and goes, then you should seek help from your GP or be referred to a rapid access chest pain clinic to see a cardiologist.


When is chest pain a medical emergency?

Sudden onset of chest pain with the features described above is an emergency and you should dial 999 for an ambulance immediately.

By Dr Amarjit Sethi

Dr Amarjit Sethi is an experienced consultant cardiologist based in London, Brentwood and Hemel Hempstead, who is an expert in the diagnosis and treatment of coronary artery disease. He has a special interest in coronary angiography and coronary angioplasty and insertion of permanent pacemakers. He is an expert in cardiac CT and intravascular imaging and intravascular ultrasounds. He also treats patients with acute heart attacks. 

Dr Sethi completed his medical studies at the United Medical and Dental Schools of Guy’s and St Thomas’ in 1992 receiving his BSc.(Hons) in immunology and prizes in medicine, pharmacology and immunology. He undertook his training at the Royal Brompton, London Chest Hospital and St Bartholomew’s Hospital.

His PhD thesis was on the mechanisms and modulation of vascular cell dysfunction at the William Harvey Research Institute, Queen Mary University of London. This research was published and presented at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology meeting and the European Society of Cardiology. Dr Sethi’s current research areas include acute coronary syndromes and the physiological assessment of coronary disease.

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