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Chest Pain

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Does this describe your symptoms?

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Definition

  • Uncomfortable pressure, fullness, squeezing, or other pain in the chest

  • This includes the area from the clavicles to the bottom of the rib cage

General Information

  • Not all chest pain is serious, but until your doctor has examined you it is always safer to assume that your chest pain is serious.

  • The most life-threatening cause of chest pain is a heart attack. Other serious causes include angina, pneumonia, lung blood clots, or a collapsed lung.

  • Some common causes of chest pain are not serious  (e.g., muscle strain, chest wall arthritis, and acid reflux).

Heart Attack Warning Symptoms

  • Chest pain or discomfort. The typical heart attack pain is located in the center of the chest and lasts more than a few minutes. Usually the discomfort feels like pressure, squeezing, or heaviness.

  • Pain or discomfort in other areas of the upper body. Some people who have heart attack have pain or discomfort in the upper arms, jaw, neck, or upper back.

  • Shortness of breath. Shortness of breath can sometimes occur.

  • Other symptoms. Other symptoms that can occur include unusual sweating, nausea, and lightheadedness.

If you think that you are having a heart attack, then you should call 911 (an ambulance) immediately!

 

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When to Call Your Doctor

call 911

Call 911 Now (you may need an ambulance) If

  • Passed out (fainted)

  • Very weak (can't stand)

  • Visible sweat on face or sweat is dripping down face

  • Severe difficulty breathing (e.g., struggling for each breath, unable to speak)

  • Lips or face are blue

  • Severe chest pain

  • Chest pain lasting longer than 5 minutes and any of the following:

    • Pain is crushing, pressure-like, or heavy

    • History of heart disease (e.g., angina, heart attack, bypass surgery, angioplasty)

    • Over 50 years old

    • Over 30 years old and you have at least one cardiac risk factor (i.e. high blood pressure, diabetes, high cholesterol, obesity, smoker or strong family history of heart disease)

    • Took nitroglycerin and was not relieved

call now

Call Your Doctor Now (night or day) If

  • You feel weak or very sick

  • Chest pain lasts more than 5 minutes

  • Chest pain brought on by exertion and relieved by rest

  • Chest pain spreads into your shoulder, arm, or jaw

  • You have angina chest pain and it has been increasing in severity or frequency

  • Difficulty breathing or taking a breath makes pain worse

  • Coughing up blood

  • Dizziness, lightheadedness, or weakness

  • Heart beating irregularly or very rapidly

  • Fever

  • Major surgery in the past month

  • Any prior "blood clot" in leg or lungs (Note: typically would have required treatment with a blood thinner such as heparin or coumadin)

  • Hip or leg fracture in past two months

  • Recent illness requiring prolonged bed rest within last month

  • Recent long distance travel with prolonged time in car, bus, plane, or train (i.e., in past 3 weeks; 6 or more hours duration)

  • Drug abuse

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think you need to be seen

  • Rash in same area as pain (especially if described as "small blisters")

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Intermittent mild chest pain lasting a few seconds each time, and persists for more than 3 days

  • Chest pain only when coughing and persists for more than 3 days

home care

Self Care at Home If

  • Intermittent mild chest pain lasting a few seconds each time, and you don't think you need to be seen

  • Mild chest pain only when coughing, and you don't think you need to be seen

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HOME CARE ADVICE

Home Care Advice for Mild Chest Pain

  1. Fleeting Chest Pain: Fleeting chest pains that last only a few seconds and then go away are generally not serious. They may be from pinched muscles or nerves in your chest wall.

  2. Chest Pain Only When Coughing: Chest pains that occur with coughing generally come from the chest wall and from irritation of the airways. They are usually not serious.

  3. Cough Medicines:

    • OTC Cough Syrups: The most common cough suppressant in OTC cough medications is dextromethorphan. Often the letters "DM" appear in the name.

    • OTC Cough Drops: Cough drops can help a lot, especially for mild coughs. They reduce coughing by soothing your irritated throat and removing that tickle sensation in the back of the throat. Cough drops also have the advantage of portability - you can carry them with you.

    • Home Remedy - Hard Candy: Hard candy works just as well as medicine-flavored OTC cough drops. Diabetics should use sugar-free candy.

    • Home Remedy - Honey: An old home remedy has been shown to help decrease coughing at night. The adult dosage is 2 teaspoons (10 ml) at bedtime.

  4. Expected Course: These mild chest pains usually disappear within 3 days.

  5. Call Your Doctor If:

    • Severe chest pain

    • Constant chest pain lasting longer than 5 minutes

    • Difficulty breathing

    • Fever

    • You become worse

Additional Internet Resources

  1. Heart Attack Symptoms and Warning Signs:

    • The American Heart Association provides helpful information about heart attack, stroke and other diseases.

    • Available online at: http://www.heart.org/

  2. Women and Heart Disease:

    • Womenshealth.Gov provides answers to a number for frequently asked questions.

    • Available online at: http://womenshealth.gov/

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Online Medical Reviewer: Louise Akin, RN, BSN
Online Medical Reviewer: Daphne Pierce-Smith, RN, MSN, FNP, CCRC
Last Review Date: 2/21/2012
© 2000-2014 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.