Chest pain can be as simple as heartburn or as dangerous as a life-threatening heart attack.

Given its uncertainty, checking every twinge helps ensure it isn’t something serious. Understand the signs and symptoms of heart issues so you know when to call your primary care provider (PCP) or 911.

What Is Chest Pain?

Chest pain is a dull ache, sharp pain, or deep pressure under your sternum. The pain differs for everyone, and it also feels different for everyone. It can be:

  • Aching

  • Burning

  • Crushing

  • Dull

  • Sharp

  • Tight

Chest pain can last just a second to several minutes, and its severity can range from mild to intense.

Sometimes, chest pain occurs during an activity, but other times, during rest. It can also spread from your chest to your neck, jaw, arms, shoulders, or back.

Chest pain is often a warning sign for something more serious. Any chest pain is a cause for concern, but especially if it's sudden and severe.

Always take note of what symptoms you're experiencing — not only how it feels but when it occurs — to share with your provider.

What Is Angina?

Angina is a kind of chest pain that occurs when your heart muscle isn’t getting enough oxygen from blood. It usually happens when you have one or more coronary arteries blocked, known as ischemia.

Often, pain from angina feels like pressure or squeezing and can spread throughout the upper body. You may also have other symptoms, such as shortness of breath, nausea with or without vomiting, profuse sweating, extreme fatigue, and weakness.

Angina is a warning sign of a larger issue, such as coronary heart disease. It can come in many forms, including:

  • Microvascular angina — Pain lasting more than 20 minutes that's a symptom of coronary microvascular disease.

  • Prinzmetal angina — When physical work or emotional stress triggers pain when resting. While very painful, it's treatable with medication.

  • Refractory angina — Long-term chest pain that doesn't improve with medication or surgery.

  • Stable angina — Pain that happens when you engage in physical activity or experience strong emotions.

  • Unstable angina — Sudden pain while you're resting that's an emergency.

Angina in women vs. men

According to the American Heart Association, coronary microvascular disease is more likely to affect women than men. Women need to be extra vigilant if they're experiencing chest pain or angina symptoms — early treatment can help prevent a heart attack.

Chest tightness, pressure, or discomfort that comes and goes are angina symptoms for both men and women. But women may also have:

  • Nausea and vomiting.

  • Pain in the neck, jaw, throat, abdomen, or back.

  • Shortness of breath.

Since these symptoms aren't as connected to heart disease, they're easy to dismiss or ignore.

Your risk of angina increases with age. Other risk factors include:

  • Conditions such as high blood pressure, anemia, or another heart-related issue.

  • Family history of heart issues.

  • Lifestyle habits such as a lack of physical activity, stress, smoking, or an unhealthy diet.

Always talk to your PCP if you have symptoms of angina, especially if you have any risk factors.

What Causes Chest Pain?

Chest pain is a symptom of anything from hurt ribs to more serious conditions. It could be an issue with another organ, like a blockage or infection in the lungs. Heavy lifting, stress, indigestion, anxiety, or a panic attack can also cause chest pain.

But chest pain is most connected to heart issues. These heart conditions can cause chest pain:

  • Aortic dissection — Life-threatening condition that has sudden, sharp chest pain as a symptom. It occurs when the wall of your aorta tears. Call 911 right away.

  • Coronary artery disease — Cholesterol buildup narrows or blocks your arteries, raising your risk of a heart attack or stroke.

  • Heart attack — Blocked blood flow to your heart. No oxygen and no blood mean your heart can’t pump. Call 911 right away.

  • Heart rhythm problems — Your heart beats too fast, too slow, or abnormally.

  • Heart valve problems — Valves narrow or leak, also known as aortic stenosis.

  • Hypertrophic cardiomyopathy — Heart muscle issue that makes walls in the heart chamber thicker and stiff, reducing blood flow.

  • Pericarditis — Inflammation in the tissues that surround the heart.

With so many possibilities, your provider will recommend tests to reach the right diagnosis. For instance, you may have an electrocardiogram (EKG), stress test, blood test, x-ray, or cardiac MRI.

What Should I Do About Chest Pain?

Only a trained medical professional can diagnose and treat your chest pain. Chest pain often warrants an emergency — getting treatment quickly is important, especially if you're having signs of a heart attack.

Signs of a heart attack

A heart attack is a life-threatening condition. Call 911 right away.

Signs of a heart attack include:

  • Chest pain or discomfort.

  • Dizziness or light-headedness.

  • Nausea or vomiting.

  • Obvious and fast heartbeats.

  • Pain or tingling down the left side of the arm or along the jaw, neck, or upper back.

  • Shortness of breath.

  • Unexplained sweatiness or a cold sweat.

Chest pain isn't always present for a heart attack, and women often experience different heart attack symptoms than men. They may experience more of a pressure or tightness than a pain. For women, heart attack symptoms often include:

  • Anxiety.

  • Extreme fatigue and weakness.

  • Nausea or vomiting.

  • Pain in the shoulder, back, or arm.

  • Shortness of breath.

  • Upset stomach.

Don’t hesitate to call for help if something feels wrong. It could save your life.

Getting Care Quickly After a Heart Attack

Getting care as quickly as possible when a heart attack occurs is important. The sooner treatment happens, the better the odds of survival. The longer you go without oxygen, the more damage to the brain and other bodily functions — leading to future issues.

For a STEMI (ST-Elevation Myocardial Infarction) heart attack, the goal for most medical professionals is to unblock the artery within 90 minutes.

Doctors start with an electrocardiogram or EKG to confirm the problem is with the heart and ensure proper treatment. They then unblock the artery using certain drugs or with an angioplasty or stent procedure.

When to go to the emergency department

If you have severe chest pain and heart attack symptoms, call 911 immediately. Timing is crucial for protecting your heart muscle.

Never drive yourself to the emergency department — it puts you and others at risk. Even someone else driving you is risky. The best thing to do is to call 911 so, as quickly as possible, medical professionals who know what to do can get to you.

Beyond chest pain, other symptoms that may indicate an emergency include:

  • Fainting.

  • Head or neck injury.

  • Seizures.

  • Trouble breathing.

Chest Pain Treatment

Since chest pain has so many possible causes, treatment varies. To determine the right treatment, your provider needs to diagnose your specific issue. But some common treatments for chest pain include:

  • Heart procedures to open blocked arteries.

  • Lifestyle changes, including exercise and a healthy diet.

  • Medications that help keep arteries open.

  • Medications to treat high blood pressure, high cholesterol, and diabetes.

These treatments can help with your pain as well as lower your risk for a heart attack.

Talk to Your Doctor About Chest Pain

Chest pain is most linked to heart issues. Always check in with your PCP about symptoms you're experiencing, even if they seem mild.

Remember, you should never dismiss chest pain.

Your provider can help guide you on the right path to treatment. You can also reach out to our experts at the UPMC Heart and Vascular Institute to learn more and sign up for heart screenings.