Topic Overview

Chest pain and heart attack

Chest discomfort or pain may be a key warning symptom of a heart attack. Heart attack symptoms may include:

• Chest pain or pressure, or a strange feeling in the chest.
• Sweating.
• Shortness of breath.
• Nausea or vomiting.
• Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
• Lightheadedness or sudden weakness.
• A fast or irregular heartbeat.

Chest discomfort or pain that comes on or gets worse with exercise, stress, or eating a large meal and goes away with rest may also be a warning symptom of heart disease.

If you have any of these symptoms of a heart attack, call 911 or other emergency services immediately. After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself. Since most of the damage to the heart muscle during a heart attack occurs in the first 6 hours, emergency treatment may prevent damage to the heart muscle and death. For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms like shortness of breath, nausea, numbness, tingling, or a strange feeling in your chest or other areas.

Other causes of chest discomfort or pain

Most people fear that chest pain always means that something is wrong with the heart. This is not the case. Chest discomfort or pain, especially in people who are younger than age 40, can have many causes.

• Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a type of chest pain or discomfort that happens when there is not enough blood flow to the heart. Angina is a symptom of heart disease that slows blood flow to the heart. Angina is called stable angina when it occurs at fairly predictable times, usually with activity or exertion. It is relieved by rest and may continue without much change for years. Stable angina develops after a predictable amount of exertion or emotion and usually lasts 1 to 5 minutes. A change in the usual pattern of stable angina means that the blood flow has become more impaired (called unstable angina). It is a warning sign that a heart attack may soon occur.
• Pain in the muscles or bones of the chest often occurs when you increase your activities or add exercise to your schedule. This is sometimes called chest wall pain.
• Costochondritis is an inflammation of the joints formed by the cartilage connecting the ribs to the breastbone (sternum). The inflammation could be caused by an injury to the chest, but often the reason for the inflammation is not known.
• Burning chest pain that occurs when you cough may be caused by an upper respiratory infection caused by a virus.
• Burning chest or rib pain, especially just before a rash appears, may be caused by shingles.
• An injury such as a broken rib or bruised lung can be quite painful, especially when you cough or try to take a deep breath.
• Swelling (inflammation) of the thin layers of tissue (pleura) covering the lungs and the chest wall may occur. This is called pleurisy.
• Gastroesophageal reflux disease (GERD) can cause pain just below the breastbone. Many people will say they have "heartburn." This pain is usually relieved by taking an antacid or eating.

Other, more serious problems that can cause chest pain include:

• A collapsed lung (pneumothorax), which usually causes a sharp, stabbing chest pain and occurs with shortness of breath.
• A blood clot in the lung (pulmonary embolism), which usually causes deep chest pain with the rapid development of extreme shortness of breath.
• Lung cancer, which may cause chest pain, especially if the cancer cells spread to involve the ribs.
• Diseases of the spine, which can cause chest pain if the nerves in the spine are "pinched."

Check your symptoms to decide if and when you should see a doctor.