When is chest pain related to your heart? Red flags and signs to look for

Written in association with: Dr Nicholas Robinson
Published: | Updated: 16/12/2024
Edited by: Karolyn Judge

Chest pain is a common symptom that can range from mild discomfort to a severe and alarming sensation. While not all chest pain is heart-related, it’s crucial to identify potential red flags that may indicate a cardiac issue. Knowing when to seek medical attention could be life-saving.

 

Man with heart-related chest pain

 

Is all chest pain heart-related?

 

Chest pain has many possible causes, and not all of them are linked to the heart. Common non-cardiac causes include:

  • Musculoskeletal pain: Strained chest muscles or rib injuries.
  • Gastrointestinal issues: Conditions like acid reflux or oesophageal spasms.
  • Respiratory problems: Such as pleurisy or pneumonia.

 

However, heart-related chest pain should always be ruled out first due to its potentially life-threatening implications.

 

 

Red flags: When chest pain might be heart-related

 

Heart-related chest pain often presents in distinct ways. Key red flags include:

  1. Pressure or tightness: A feeling of heaviness or squeezing in the chest, often described as "an elephant sitting on the chest."
  2. Radiating pain: Discomfort spreading to the arms, jaw, neck, back or shoulders.
  3. Shortness of breath: Difficulty breathing, even at rest or with minimal exertion.
  4. Nausea and sweating: Accompanying cold sweats, dizziness or vomiting.
  5. Worsening with exertion: Pain that increases during physical activity and eases with rest.
  6. Lasting pain: Discomfort that persists for more than a few minutes or comes and goes in waves.

 

 

Conditions to be aware of

 

Heart-related chest pain can result from various conditions, including:

  • Angina: Caused by reduced blood flow to the heart muscles, typically due to coronary artery disease.
  • Heart attack (myocardial infarction): A blockage in the blood supply to the heart, requiring immediate attention.
  • Pericarditis: Inflammation of the sac surrounding the heart, causing sharp pain that may worsen with deep breaths or lying flat.
  • Aortic dissection: A rare but serious condition where the inner layer of the aorta tears, causing sudden, severe chest or back pain.

 

 

What to do if you suspect heart-related chest pain

 

If you or someone else experiences symptoms suggestive of a heart problem:

  • Call emergency services immediately: Don’t wait to see if symptoms improve, especially if red flags are present.
  • Chew an aspirin: If you are not allergic, taking aspirin may help thin the blood while waiting for medical help.
  • Rest and remain calm: Avoid physical exertion until help arrives.

 

Chest pain is not always a sign of a heart problem, but recognising the red flags of cardiac-related chest pain is critical. If you experience symptoms such as pressure, radiating pain, or breathlessness, seek medical advice without delay. Early intervention can significantly improve outcomes in heart-related conditions. Always prioritise your health and consult a healthcare professional for any unexplained chest discomfort.

By Dr Nicholas Robinson
Cardiology

Dr Nicholas Robinson is a highly skilled consultant interventional cardiologist with more than 25 years of experience, based in London and Essex. He has performed over 4500 stent procedures with excellent publicly reported outcomes. Dr Robinson graduated from Cambridge University and went on to complete his clinical training at major prestigious teaching centres in London. Dr Robinson specialises in the diagnosis and treatment of angina and heart attack, as well as being an expert in stent insertion. 

During his time at The London Chest Hospital and St Bartholomew's Hospital, Dr Robinson published widely on the use of stents in treating coronary disease, for which he was awarded a British Heart Foundation Research Fellowship and was an academic clinical lecturer.

As well as providing care for many patients with angina, heart failure and chest pain, Dr Robinson is also committed to training doctors in aspects of coronary intervention and has lectured at numerous national and international conferences. Dr Robinson is currently working at the Essex Cardiothoracic Centre where he has helped develop the heart attack services at this well-known hospital since 2003.

View Profile

Overall assessment of their patients


  • Related procedures
  • Heart attack
    Arrhythmia
    Hypertension (high blood pressure)
    Pericarditis
    Heart failure
    Injury valves
    Heart murmur
    Echocardiogram
    Electrocardiogram
    Ambulatory electrocardiogram (Holter)
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.