Chest pain has many causes and most are not important but it can indicate a problem with your heart. Getting an accurate diagnosis of what is causing your chest pain is therefore important. Assessing your symptoms and arranging suitable tests to identify the cause of your chest pain will allow you to receive the correct diagnosis and appropriate treatment.
Chest Pain Symptoms
Pain that is due to a problem with your heart is typically felt centrally behind the breastbone though it can be felt on the left side of your chest, in your back, neck and arms. The pain may feel like pressure or tightness in your chest. There may be particular triggers to your pain such as physical activity or taking a deep breath. Other symptoms such as breathlessness, dizziness, sweating or nausea are also relevant as they may assist in determining the cause of your pain.
Causes of Chest Pain
There are many causes of chest pain and most are not particularly concerning. These include musculoskeletal problems (problems with the bones and joints in the chest) and the pains often resolve spontaneously over time.
There are other causes of chest pain which are not related to the heart such as heartburn or other problems with the gut and lung disease.
The commonest heart problems to cause chest pain are angina and a heart attack. Angina is where the arteries that supply blood to the heart (the coronary arteries) have become narrowed so that they are unable to deliver an increase in the supply of oxygen and nutrients when the heart needs to work harder than at rest (such as during exercise). A heart attack is where one or more of the arteries that supply the heart has become severely narrowed or blocked. This is a medical emergency and requires immediate treatment to restore the blood flow to the heart.
There are other less common causes of chest pain due to a problem with the heart. These include problems such as narrowing of the aortic valve, inflammation of the heart muscle (myocarditis) and inflammation of the lining of the heart (pericarditis).
Investigating Chest Pain
Your symptoms of chest pain and your previous medical history will help determine which investigations you require. These will include an ECG which is usually performed at the time of the consultation. More specialist investigations may be recommended such as specialised scans of your heart (which may include an echocardiogram or a cardiovascular MRI) or more invasive procedures such as a coronary angiogram.