Chest pain is a common reason for seeking medical help, and it can be caused by a wide range of conditions. While some causes are mild and harmless, others can be life-threatening and require immediate treatment. Knowing when chest pain is an emergency and when it can be safely monitored at home can make a significant difference to your health and peace of mind.
This article explains how to recognise dangerous symptoms, what steps to take in the first moments, how healthcare professionals investigate chest pain, and what to track if your symptoms are mild or intermittent. If you are ever in doubt, it is always safest to get medical advice promptly.
Symptoms that need urgent action
Some symptoms associated with chest pain should never be ignored. They may indicate a heart attack, a dangerous heart rhythm, a blood clot in the lungs, or another medical emergency. Seek immediate medical help if you experience any of the following:
- Sudden, severe chest pain or pressure that lasts more than a few minutes, especially if it feels like heaviness, squeezing, or tightness
- Pain spreading to the left arm, neck, jaw, back, or stomach
- Shortness of breath or trouble breathing, especially if it comes on suddenly
- Nausea, vomiting, cold sweats, or dizziness along with chest pain
- A feeling of impending doom or sudden anxiety for no clear reason
- Loss of consciousness or fainting
- Rapid or irregular heartbeat
- Coughing up blood
- Chest pain that started after physical exertion or emotional stress
- Chest pain in someone with known risk factors, such as previous heart disease, diabetes, or recent surgery
If you or someone you are with has these symptoms, call emergency services (e.g., 112 in Europe, 999/911 in other regions) without delay. Stay as calm as possible and follow the instructions from the emergency operator.
When chest pain can be monitored
Not all chest pain is dangerous. Sometimes, it is caused by less serious issues such as:
- Muscle strain from coughing, heavy lifting, or unusual exercise
- Heartburn or indigestion
- Anxiety or panic attacks
- Minor respiratory infections
- Costochondritis (inflammation of the cartilage in the chest wall)
Chest pain may be less concerning if:
- The pain is mild, clearly related to movement or position, and improves with rest
- It is brief and does not return
- There are no other symptoms such as breathlessness, sweating, or nausea
- You have had similar pain before and it was diagnosed as harmless by a doctor
Even if your symptoms seem mild, it is wise to speak to a healthcare professional if the pain is new, unexplained, or you are unsure about the cause. Always err on the side of caution, especially if you have risk factors such as older age, high blood pressure, diabetes, or a family history of heart disease.
What to do in the first 10 minutes
If you experience sudden, severe, or unexplained chest pain, the first 10 minutes are critical. Here is what you should do:
- Stop what you are doing and sit down. Try to stay calm and rest.
- Call emergency services immediately if the pain is severe, lasts more than a few minutes, or is associated with warning symptoms (see above).
- If you have been prescribed nitroglycerin (GTN) spray or tablets for angina, use it as instructed by your doctor.
- If you are not allergic and have no contraindications, an emergency operator may advise you to chew an aspirin (300 mg) while waiting for help to arrive. Do not do this unless advised by a professional.
- Do not attempt to drive yourself to the hospital if you feel unwell or dizzy. Wait for emergency responders.
- If you are with someone who collapses or becomes unresponsive, call for help and begin CPR if trained to do so.
Remember, timely action can save lives. It is always better to be safe and get checked if you are unsure.
What doctors will ask and test
When you see a doctor for chest pain, they will take a detailed history and perform an examination to help determine the cause. You may be asked questions such as:
- When did the pain start and how long did it last?
- What does the pain feel like (sharp, dull, stabbing, pressure)?
- Where is the pain located, and does it move anywhere else?
- What were you doing when the pain began?
- Are there any associated symptoms (breathlessness, sweating, nausea, palpitations)?
- Do you have a history of heart, lung, or digestive problems?
- Are you taking any medications?
Depending on your symptoms and risk factors, the doctor may perform tests such as:
- Physical examination: checking your pulse, blood pressure, breathing, and listening to your heart and lungs
- Electrocardiogram (ECG): to look for signs of heart attack or abnormal rhythms
- Blood tests: to check for markers of heart damage (such as troponin), infection, or anaemia
- Chest X-ray: to look for lung problems, infection, or other causes
- Other imaging: such as echocardiography or CT scan, if needed
Not all tests will be needed in every case; your doctor will decide based on your situation. Sometimes, observation in a hospital or further specialist testing may be recommended.
What to track if symptoms come and go
If your chest pain is mild, infrequent, or has already been checked by a doctor and found to be non-urgent, it is still important to monitor your symptoms. Keeping a symptom diary can help your doctor with diagnosis and treatment. You may want to record:
- Date and time when symptoms occur
- Duration of pain episodes
- Triggers (such as exercise, stress, food, or position)
- Description of the pain (sharp, dull, burning, etc.)
- Associated symptoms (breathlessness, palpitations, nausea, etc.)
- Actions taken (rest, medications, etc.) and their effect
Share this information with your healthcare provider, especially if:
- Your symptoms are getting worse or more frequent
- New symptoms develop
- Pain starts occurring with less effort or at rest
Regular follow-up with your doctor ensures your condition is properly monitored and managed.
If you notice chest pain accompanied by breathing difficulties, it is important to be aware of warning signs; you can learn more about serious causes by reading our guide on red flags for shortness of breath.
In summary: Chest pain can have many causes, some of which are medical emergencies. Recognising dangerous symptoms and knowing when to seek urgent help can save lives. For milder pain, careful monitoring and timely medical advice are important. If you are ever unsure, it is always better to get a professional opinion. Your health and safety are the priority.
