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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Chest pain

Chest tightness; Chest pressure; Chest discomfort

Last reviewed: May 13, 2014.

Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.

Considerations

Many people with chest pain fear a heart attack. However, there are many possible causes of chest pain. Some causes are not dangerous to your health, while other causes are serious and, in some cases, life-threatening.

Any organ or tissue in your chest can be the source of pain, including your heart, lungs, esophagus, muscles, ribs, tendons, or nerves. Pain may also spread to the chest from the neck, abdomen, and back.

Causes

Heart or blood vessel problems that can cause chest pain:

Lung problems that can cause chest pain:

Other causes of chest pain:

Chest pain can also be due to the following digestive system problems:

  • Spasms or narrowing of the esophagus (the tube that carries food from the mouth to the stomach)
  • Gallstones cause pain that gets worse after a meal (most often a fatty meal).
  • Heartburn or gastroesophageal reflux (GERD)
  • Stomach ulcer or gastritis: Burning pain occurs if your stomach is empty and feels better when you eat food

In children, most chest pain is not caused by the heart.

Home Care

For most causes of chest pain, it is best to check with your doctor or nurse before treating yourself at home.

Heart attack symptoms

When to Contact a Medical Professional

Call 911 if:

  • You have sudden crushing, squeezing, tightening, or pressure in your chest.
  • Pain spreads (radiates) to your jaw, left arm, or between your shoulder blades.
  • You have nausea, dizziness, sweating, a racing heart, or shortness of breath.
  • You know you have angina and your chest discomfort is suddenly more intense, brought on by lighter activity, or lasts longer than usual.
  • Your angina symptoms occur while you are at rest.
  • You have sudden, sharp chest pain with shortness of breath, especially after a long trip, a stretch of bedrest (for example, following an operation), or other lack of movement, especially if one leg is swollen or more swollen than the other (this could be a blood clot, part of which has moved to the lungs).
  • You have been diagnosed with a serious condition, such as heart attack or pulmonary embolism.

Your risk of having a heart attack is greater if:

Call your doctor if:

  • You have a fever or a cough that produces yellow-green phlegm
  • You have chest pain that is severe and does not go away
  • You are having problems swallowing
  • Chest pain lasts longer than 3 to 5 days

What to Expect at Your Office Visit

Your doctor may ask questions such as:

  • Is the pain between the shoulder blades? Under the breast bone? Does the pain change location? Is it on one side only?
  • How would you describe the pain? (severe, tearing or ripping, sharp, stabbing, burning, squeezing, tight, pressure-like, crushing, aching, dull, heavy)
  • Does it begin suddenly? Does the pain occur at the same time each day?
  • Does the pain get better or worse when you move?
  • Can you make the pain happen by pressing on a part of your chest?
  • Is the pain getting worse? How long does the pain last?
  • Does the pain go from your chest into your shoulder, arm, neck, jaw, or back?
  • Is the pain worse when you are breathing deeply, coughing, eating, or bending?
  • Is the pain worse when you are exercising? Is it better after you rest? Does it go away completely, or is there just less pain?
  • Is the pain better after you take nitroglycerin medicine? After you eat or take antacids? After you belch?
  • What other symptoms do you have?

The types of tests that are done depend on the cause of the pain, and what other medical problems or risk factors you have.

References

  1. Anderson JL, Adams CD, Antman EM, et al. ACC/AHA Guidelines for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). Circulation. 2007;116:803-877. [PubMed: 12356647]
  2. Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 50.
  3. Sabatine MS, Cannon CP. Approach to the patient with chest pain. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 53.
  4. Jneid H, Anderson JL, Wright RS, et al. 2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guidelines and Replacing the 2011 Focused Update). Circulation. 2012;126. [PubMed: 22800849]

Review Date: 5/13/2014.

Reviewed by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Injection of Chinese herbal extract for chest pain of unstable anginaInjection of Chinese herbal extract for chest pain of unstable angina
    Chest pain or discomfort in the chest can occur when the heart is not pumping enough blood, thus depriving the heart muscle of oxygen. The condition is called angina pectoris. When the same symptoms occur at rest or become severe, unstable angina is the diagnosis. Unstable angina is treated as an emergency. In China, doctors have been using an injection of the herbal extract, puerarin, as a treatment for heart disease and for unstable angina. Puerarin is extracted from the herb, puerariae lobata, which is also known as kudzu or by its Chinese name, Gegen.
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