Chest Pain: Symptoms, Causes & Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Chest pain is pain or discomfort anywhere between the neck and the belly. It can be sharp or dull, constant or intermittent, and it comes from many possible causes — the most life-threatening involve the heart or lungs. The most common serious signs are pressure, tightness, or squeezing in the chest that may spread to the arm, back, neck, jaw, or upper belly, along with shortness of breath, cold sweats, or nausea. If a heart attack seems possible, call 911 immediately and never wait out of embarrassment. Doctors diagnose the cause with fast tests — an ECG, blood tests, chest X-ray, and CT scan — and treatment ranges from aspirin and nitroglycerin to angioplasty with a stent or open-heart surgery, depending on the cause.
Quick Answer
What causes chest pain, and when is it an emergency?
Chest pain is pain or discomfort in the area between the neck and belly; it may be sharp or dull, constant or intermittent.
The most life-threatening causes involve the heart (heart attack, angina, aortic dissection, pericarditis) or lungs (blood clot, collapsed lung, pleurisy, pulmonary hypertension).
Call 911 right away for pressure, tightness, or squeezing in the chest — especially if it spreads to the shoulder, arm, back, neck, jaw, teeth, or upper belly, or comes with shortness of breath, cold sweats, or nausea.
Emergency doctors test for heart attack first: an ECG (electrocardiogram), blood tests, chest X-ray, and possibly a CT scan.
Treatment depends entirely on the cause — from aspirin, nitroglycerin, and acid-reducing medicine to angioplasty with stent placement, bypass surgery, or emergency aorta repair.
Heartburn-like burning behind the breastbone can come from the stomach or the heart — it cannot be self-diagnosed by sensation alone.
Do not delay care for fear of embarrassment if it turns out not to be a heart attack; unexplained chest pain always needs prompt medical evaluation.
What Is Chest Pain?
Chest pain is pain or discomfort in the area between the neck and the belly. The sensation can be sharp or dull, and it may come and go or stay constant. The exact symptoms depend entirely on the underlying cause.
Many different things can cause chest pain, and the most life-threatening causes involve the heart or the lungs. Because the same sensation can come from something serious or something minor, getting medical help for an accurate diagnosis is essential.
If you think your chest pain may be due to a heart attack, call 911 or your local emergency number right away. Never ignore the symptoms of a heart attack.
Chest pain covers the area between the neck and the belly. Because the most serious causes involve the heart or lungs, possible heart-attack symptoms always need emergency care.
What Does Chest Pain Feel Like?
Heart-related chest pain is often described as pressure, tightness, squeezing, or aching in the chest. Because heart symptoms vary widely, the full picture matters more than any single sensation.
According to clinical guidance, chest pain from a heart attack or another heart condition may include the following:
Chest pressure: Tightness, squeezing, or aching in the chest
Radiating pain: Spreads to the shoulder, arm, back, neck, jaw, teeth, or upper belly
Shortness of breath: Trouble catching your breath at rest or with light activity
Cold sweats: Sudden sweating with chills
Lightheadedness: Feeling faint or unsteady
Fast heartbeat: Pounding or racing heart
Nausea: Queasy stomach, sometimes with vomiting
Fatigue: Unusual tiredness or weakness
Heartburn-like feeling: Burning or indigestion that may actually be cardiac
Other types of chest pain can overlap with these symptoms, which is why self-diagnosis is unreliable. Pain is generally less likely to be heart-related if it appears alongside a sour taste or food coming back up into the mouth, trouble swallowing, pain that changes with body position, pain that worsens with a deep breath or cough, tenderness when pressing on the chest, or pain that lasts many hours or days.
However, there is a critical exception: the classic burning sensation of heartburn — felt behind the breastbone — can be caused by a condition affecting the heart or the stomach. A burning sensation alone cannot rule out a heart problem.
When Should You Seek Immediate Care?
If you have new or unexplained chest pain, or think you are having a heart attack, call 911 or emergency medical help right away. Never ignore the symptoms of a heart attack.
Possible heart attack: Call 911 immediately
Severe chest pain or pressure lasting more than a few moments: Call 911 immediately
New or unexplained chest pain or pressure: Call 911 or seek emergency care immediately
No ambulance available: Have someone drive you to the nearest hospital; drive yourself only if you have no other option
Sudden sharp chest pain with shortness of breath (possible collapsed lung or blood clot): Seek emergency care immediately
Intense fear with chest pain, pounding heart, and sweating (possible panic attack): Get medical help — a panic attack can be hard to tell from a heart attack
The source material is explicit about hesitation: don't waste any time out of fear of embarrassment if it turns out not to be a heart attack. Even if the cause is something else, you need to be seen right away.
What Causes Chest Pain?
Chest pain has many possible causes. The table below organizes them by body system, with a one-line description of each condition's pain pattern.
Chest pain causes fall into four groups — heart and blood vessels, digestive system, lungs, and muscle, bone, and other conditions. The most life-threatening causes involve the heart or lungs.
Heart and Blood Vessel Causes
Angina is any chest pain caused by reduced blood flow to the heart muscle. It is often described as squeezing, pressure, heaviness, tightness, or pain in the chest. Angina is a symptom of coronary artery disease. Unstable angina can cause a heart attack or near heart attack.
Heart attack happens when blood flow to the heart muscle is blocked. It can cause angina-type chest pain, and emergency treatment is needed to prevent death.
Aortic dissection is a life-threatening condition involving the body's main artery, called the aorta. If the inner layers of the aorta separate, blood is forced between the layers, which can cause the aorta to rupture.
Pericarditis is inflammation of the sac around the heart. It usually causes sharp pain that gets worse when taking a breath or lying down.
Digestive Causes
Chest pain can come from diseases or disorders of the digestive system.
GERD (gastroesophageal reflux disease) occurs when stomach acid washes up from the stomach into the tube that connects the throat to the stomach — the esophagus. GERD can cause a burning feeling in the chest called heartburn.
Swallowing disorders affecting the esophagus can make swallowing difficult and painful, which may lead to chest pain.
Gallbladder or pancreas disease — such as gallstones or inflammation — can cause stomach pain that spreads to the chest.
Lung-Related Causes
Several lung conditions cause chest pain that can mimic a heart attack.
A pulmonary embolism — a blood clot stuck in a lung artery — blocks blood flow to lung tissue, and its symptoms may feel like a heart attack.
Pleurisy is irritation of the thin tissue layers that separate the lungs from the chest wall; it causes sharp chest pain that worsens when breathing in or coughing.
A collapsed lung (pneumothorax) happens when air leaks into the space between the lung and the ribs; the pain typically starts suddenly, can last for hours, and usually causes shortness of breath.
Pulmonary hypertension — high blood pressure in the lung arteries — can cause chest pain or pressure.
Muscle, Bone, and Other Causes
Some chest pain comes from the chest wall itself.
Costochondritis is inflammation of the cartilage that connects a rib to the breastbone; it can feel like a heart attack and is most commonly felt on the left side of the body.
Injured ribs — bruised or broken — cause chest pain that usually follows trauma.
Long-term pain syndromes such as fibromyalgia, which makes muscles sore, can cause long-term chest-area pain.
Panic attacks — intense fear with chest pain, a fast pounding heartbeat, fast breathing, heavy sweating, shortness of breath, nausea, and dizziness — which can be hard to distinguish from a heart attack.
Shingles, an infection caused by the varicella-zoster virus (the same virus that causes chickenpox), can cause very severe pain and a band of blisters running from the back around to the chest.
Nerve pain from pinched nerves in the middle back may also be felt as chest pain.
Causes at a Glance
Angina: Squeezing, pressure, heaviness, tightness
Heart attack: Blocked blood flow; may cause angina-type pain
Aortic dissection: Life-threatening tear in the aorta
Pericarditis: Sharp; worse with a breath or lying down
GERD: Burning behind breastbone (heartburn)
Swallowing disorders: Painful or difficult swallowing
Gallbladder/pancreas disease: Stomach pain spreading to chest
Pulmonary embolism: Can feel like a heart attack
Pleurisy: Sharp; worse breathing in or coughing
Collapsed lung: Sudden onset, lasts hours, shortness of breath
Pulmonary hypertension: Chest pain or pressure
Costochondritis: Often left-sided; can feel like a heart attack
Injured ribs: Follows bruise or fracture
Panic attack: Fear with pounding heart, sweating, dizziness
Shingles: Severe pain with a band of blisters
Nerve pain: Pinched nerves in the middle back
How Is Chest Pain Diagnosed?
Chest pain does not always mean a heart attack — but that is what emergency medical help tests for first, because it can be life-threatening. Healthcare professionals also check for life-threatening lung conditions, such as a collapsed lung or a blood clot in the lung.
Immediate Emergency Tests
Electrocardiogram (ECG or EKG): Sticky sensor patches on the chest, sometimes arms and legs; wires connect to a computer that prints or displays results, showing how the heart is beating and whether you are having or have had a heart attack
Blood tests: Blood drawn and analyzed for heart proteins, which leak into the blood after heart damage from a heart attack
Chest X-ray: Imaging of the chest showing the condition of the lungs and the size and shape of the heart; can diagnose pneumonia or a collapsed lung
CT scan: X-rays create cross-sectional images of the chest that can spot a blood clot in the lung or an aortic dissection
Follow-Up Tests
Depending on the first results, additional testing may follow.
An echocardiogram uses sound waves to create images of the beating heart, showing how blood moves through the heart and its valves.
A CT coronary angiogram uses a powerful X-ray machine to image the heart and its blood vessels, and is used to diagnose many different heart conditions.
An exercise stress test has you walk on a treadmill or ride a stationary bike while a healthcare professional watches your heartbeat, showing how the heart reacts to exercise. If you cannot exercise, medicines that affect the heart the way exercise does may be used instead.
Coronary catheterization finds blockages in the heart arteries. A long, thin, flexible tube is inserted into a blood vessel — usually in the groin or wrist — and guided to the heart. Dye flows through the tube into the heart's arteries, helping them show up clearly on X-ray images and video.
How Is Chest Pain Treated?
Chest pain treatment depends entirely on what is causing the pain. The table below summarizes the medications and procedures used for the most common causes.
The chest pain care pathway moves from first symptoms to emergency response, immediate testing, and cause-specific treatment — with follow-up tests if initial results are unclear.
Medications
Nitroglycerin: Relaxes heart arteries so blood flows more easily, often as a tablet under the tongue, when pain appears to come from blocked heart arteries
Blood pressure medicines: Some relax and widen blood vessels to ease heart-related chest pain
Aspirin: Part of treatment for actual or possible heart-artery blockages when pain appears heart-related; it does not take away the pain itself
Clot-busting drugs (thrombolytics): Dissolve the clot blocking blood to the heart muscle during a heart attack
Blood thinners: Prevent future clots when a clot is in an artery to the heart or lungs
Acid-reducing medicines: Reduce stomach acid for heartburn-related pain
Anti-anxiety medicines: Ease panic symptoms for panic attacks; talk therapy such as cognitive behavioral therapy may also be recommended
Surgical and Other Procedures
Angioplasty and stent placement removes a blockage in an artery going to the heart. The doctor inserts a thin tube with a balloon on the end into a large blood vessel — usually in the groin — and guides it to the heart. The balloon expands to widen the artery, then is deflated and removed. A small wire mesh tube called a stent is often placed in the artery to keep it open.
Coronary artery bypass graft surgery (CABG) is a type of open-heart surgery. The surgeon takes a vein or artery from elsewhere in the body and uses it to create a new path for blood around a blocked or narrowed heart artery, increasing blood flow to the heart.
Emergency repair surgery may be needed for a ruptured aorta (aortic dissection), a life-threatening condition. For a collapsed lung, a healthcare professional may place a tube in the chest to reinflate the lung.
How Do You Prepare for Emergency Care?
You may not have time to prepare. If you are having severe chest pain, or new or unexplained chest pain or pressure that lasts more than a few moments, call 911 or emergency medical services.
Don't waste any time for fear of embarrassment if it turns out not to be a heart attack. Even if there is another cause for your chest pain, you need to be seen right away.
When possible, share the following with emergency medical help. Describe your symptoms in detail, noting when they started and what makes the pain better or worse. Provide your medical history — whether you've had chest pain before and what caused it, and whether you or close family members have a history of heart disease or diabetes. Bring a medicines list covering all medicines and supplements you take regularly; preparing such a list in advance and carrying it in your wallet or purse helps emergency professionals.
Once you are at the hospital, you will usually be examined quickly. Based on blood tests and a heart monitor, your healthcare professional can quickly determine whether you are having a heart attack.
If you haven't received the following information, you may want to ask about the most likely cause of your chest pain, other possible causes, the tests you need, whether you need to stay in the hospital, the treatments needed right now, any treatment risks, the next steps, how other medical conditions might affect your treatment, activity changes after you go home, and whether you should see a specialist.
Your healthcare professional will likely ask when symptoms started and whether they have worsened, whether pain spreads to other body parts, how you would describe the pain and rate it on a 1–10 scale, whether you have dizziness or trouble breathing, whether you have vomited, your blood pressure and any medicines for it, your smoking history, your alcohol and caffeine use, and whether you use illicit drugs such as cocaine.
Conclusion
Chest pain is one symptom with many possible causes — from harmless muscle strain to a life-threatening heart attack or blood clot.
The single most important fact to remember is this: new, severe, or unexplained chest pain should never be ignored. Heart-related pain can be subtle and can mimic heartburn, and lung-related pain can mimic a heart attack.
If your chest feels like it's under pressure, or the pain spreads to your arm, jaw, or back, or comes with shortness of breath, cold sweats, or nausea, call 911 right away. Don't wait, and don't worry about embarrassment — prompt emergency testing (ECG, blood tests, X-ray, CT scan) quickly determines whether your heart is in danger, and treatment is available for every cause, from simple medication to surgery.
Your next step: if you are having new or unexplained chest pain, seek emergency medical care now. If recurring chest pain worries you, schedule an evaluation with your healthcare professional — an accurate diagnosis is the only way to know what you're dealing with and how best to treat it.
Frequently Asked Questions
Is chest pain always a heart attack?
No. Chest pain has many possible causes, including GERD, costochondritis, pleurisy, panic attacks, and shingles. However, emergency teams test for a heart attack first because it is life-threatening, and only testing can confirm the true cause.
When should I call 911 for chest pain?
Call 911 right away for new or unexplained chest pain or pressure that lasts more than a few moments, especially if it feels like pressure, tightness, or squeezing, spreads to the arm, back, neck, jaw, or upper belly, or comes with shortness of breath, cold sweats, nausea, or lightheadedness.
Can heartburn feel exactly like a heart attack?
Yes — and the reverse is also true. A painful burning sensation behind the breastbone can come from a stomach problem or a heart problem. It cannot be self-diagnosed by sensation, which is why new burning chest pain always needs medical evaluation.
What tests do doctors do first for chest pain?
Emergency teams typically start with an electrocardiogram (ECG) to check the heart's rhythm, blood tests for heart proteins that leak after heart damage, a chest X-ray, and possibly a CT scan to look for a lung blood clot or aortic dissection.
Can chest pain be caused by anxiety?
Yes. A panic attack can cause intense fear with chest pain, a fast pounding heartbeat, fast breathing, heavy sweating, shortness of breath, nausea, and dizziness. Because this can be hard to tell from a heart attack, medical help is always needed when the cause is uncertain.
What is angina, and is it dangerous?
Angina is chest pain caused by reduced blood flow to the heart muscle. It is a symptom of coronary artery disease. Unstable angina can cause a heart attack or near heart attack, so it always requires medical evaluation.
What is the treatment for chest pain?
Treatment depends on the cause. It may include aspirin, nitroglycerin, blood pressure medicines, clot-busting drugs, or blood thinners for heart-related causes; acid-reducing medicines for heartburn; anti-anxiety medicines and therapy for panic attacks; or procedures such as angioplasty with stent placement, bypass surgery, emergency aorta repair, or lung reinflation.
Should I drive myself to the hospital if my chest hurts?
Only as a last resort. If you can't get an ambulance, have someone drive you to the nearest hospital. Driving yourself is recommended only if you have no other way to get there — and calling 911 is always the safest option.
How long should I wait to see if chest pain goes away?
You shouldn't wait at all for new, severe, or unexplained chest pain. Don't delay for fear of embarrassment if it turns out not to be a heart attack — even if the cause is something else, you need to be seen right away.
References
Chest pain — Symptoms and causes (Mayo Clinic)
Chest pain — Diagnosis and treatment (Mayo Clinic)
This article is based on peer-reviewed medical reference pages last reviewed December 10, 2024. Medical information changes over time — this content is for general education and is not a substitute for professional medical advice. Always consult a licensed clinician for diagnosis and treatment.
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