Chest Pain

Chest pain is one of the most common reasons people seek medical advice. It can have many different causes — not all of them serious — but some require urgent attention. The sensation can vary greatly: it may feel mild and fleeting, or sharp, heavy, tight, or burning. Sometimes it occurs only when moving or coughing, while in other cases it appears suddenly and severely. Because chest pain can signal a heart or lung condition, it’s important to pay attention to:

• Where in the chest the pain occurs
• What brings it on or makes it better
• How long it lasts and how often it happens
• Whether it is accompanied by other symptoms such as breathlessness, palpitations, dizziness, or sweating

These details help your doctor determine the likely cause and decide which investigations are needed. Below are the most common causes of chest pain and signs that require urgent medical care.

Heart-related Causes

• Angina – A tightness, pressure, or heaviness in the chest brought on by exertion or stress. It may worsen after meals and ease with rest.

• Heart Attack (Myocardial Infarction) – Severe, persistent pain that does not settle with rest. It may radiate to the throat, jaw, or left arm and be associated with sweating, nausea, or breathlessness.

• Pericarditis – Inflammation of the lining around the heart, often causing sharp pain that worsens when lying down and improves when sitting forward.

Lung-related Causes

• Pulmonary Embolism (blood clot in the lung) – Sudden, sharp pain made worse by breathing in, often with shortness of breath and sometimes coughing up blood.

• Pneumothorax (collapsed lung) – Sudden one-sided chest pain and breathlessness.

• Chest Infection or Pleurisy – Localised pain with cough, fever, or difficulty breathing.

Digestive Causes

• Heartburn (acid reflux) – Burning discomfort rising from the upper abdomen or chest, worse after eating or when lying down.

• Gallstones or Stomach Ulcers – Pain in the upper abdomen that can spread to the chest.

Musculoskeletal Causes

• Costochondritis – Pain or tenderness when pressing on the chest wall, sometimes linked to movement or strain.

• Muscle Strain – From coughing, lifting, or injury.

Other Causes

• Anxiety or Panic Attacks – Tight chest, fast heartbeat, breathlessness, or a feeling of impending panic.

• Shingles – Burning or shooting pain on one side of the chest followed by a rash.

Call 999 (or go to A&E immediately) if you experience chest pain with any of the following:

• Severe, heavy, or crushing discomfort

• Pain radiating to your arm, neck, jaw, or back

• Pain lasting longer than 15 minutes at rest

• Shortness of breath, fainting, sweating, or nausea

• Sudden sharp pain with breathlessness or coughing up blood

• Chest pain after surgery or a long flight

• If you have known heart disease, diabetes, high blood pressure, or you smoke

Book an appointment if:

• You have chest pain or pressure that keeps coming back

• You experience discomfort during activity that eases with rest

• You’re unsure whether your symptoms are serious

Your cardiologist may recommend one or more of the following tests:

• ECG (Electrocardiogram): Checks your heart rhythm and can help detect heart attacks or rhythm problems.

• Echocardiogram: An ultrasound scan assessing heart function and valve movement.

• Cardiac CT Scan: A detailed scan of the heart arteries to identify any narrowings or blockages.

• Other Tests: Chest X-ray, blood tests, or additional imaging depending on symptoms.