Chest Pain and Tightness
What is It?
Chest pain or tightness refers to any discomfort, pressure, squeezing or aching between the neck and upper abdomen. It is a very common symptom with many possible causes ranging from benign to life-threatening. While most chest pain is not heart-related, it should never be ignored – particularly if it is new, severe, prolonged, or accompanied by shortness of breath, sweating, nausea or pain radiating to the arm or jaw. Severe or persistent chest pain may be a medical emergency and requires immediate assessment by calling 000.
What are the symptoms?
Chest pain may present in many different ways depending on the cause. Heart-related chest pain often feels like pressure, squeezing, heaviness or tightness in the centre of the chest, may spread to the arms, neck, jaw, shoulders or back, and can be accompanied by shortness of breath, sweating, nausea or dizziness. Other causes of chest pain may produce sharp, stabbing, burning, or positional discomfort. The nature, timing and triggers of the pain offer important clues about the cause.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of chest pain. Causes include:
- Cardiac causes: Heart attack, angina, pericarditis, and aortic dissection.
- Digestive causes: Gastro-oesophageal reflux (heartburn), oesophageal spasm, and gallbladder disease.
- Musculoskeletal causes: Chest wall sprain, costochondritis, and rib injuries.
- Lung causes: Pulmonary embolism, pneumonia, pleurisy and pneumothorax.
- Other causes: Anxiety and panic attacks, shingles, and chest infections.
How is it investigated?
Immediate tests to assess chest pain typically include an ECG, blood tests (including cardiac troponin), and a chest X-ray. Follow-up investigations depend on the suspected cause and may include exercise stress testing, stress echocardiogram, CT coronary angiogram (CTCA), cardiac MRI, or invasive coronary angiography. Your One Heart Centre cardiologist will determine which tests are most appropriate for your symptoms.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing chest pain and will provide a personalised treatment plan for your chest pain. Treatment depends on the cause and may include:
- Lifestyle changes to improve heart health, including diet, exercise, smoking cessation and stress management.
- Medications to treat cardiovascular conditions, including aspirin, statins, beta-blockers and nitrates.
- Treatment of non-cardiac causes, such as acid reflux medications or anti-inflammatory therapy.
- In selected cases, procedures such as coronary angioplasty or surgery to address the underlying cause.