Is chest pain always coming from the heart?
Chest pain is one of the most common reasons for coming to a cardiology clinic. But not all chest pain comes from the heart: the musculoskeletal system, reflux, the lungs and anxiety disorders can all produce similar pain. What tells them apart is as much the findings that go with the pain as the pain itself.
Features that raise the chance of a cardiac cause
- Pressure, tightness or heaviness in the middle of the chest
- Pain spreading to the arm, neck, jaw or back
- Pain that starts on exertion (walking, stairs) and settles with rest
- Cold sweating, nausea and shortness of breath alongside it
- Diabetes, high blood pressure, high cholesterol or smoking
Features that suggest a non-cardiac cause
- Pain you can point to with one finger, which increases on pressing
- Pain that changes with deep breathing or coughing
- Burning that appears after meals, together with an acid taste in the mouth
- Pain that changes with arm movement or in certain positions
These distinctions point a direction; they do not make a diagnosis. Pain that looks non-cardiac can still be cardiac.
Do not wait
If your chest pain lasts longer than 15–20 minutes, does not settle with rest, or comes with cold sweating, nausea, shortness of breath or faintness, call 112. In that picture, waiting is the riskiest option.
What happens at the clinic?
Assessment starts with your history and an examination; an ECG is usually the first test. Where needed, the investigation is taken further with echocardiography, an exercise stress test or Holter monitoring. All of these can be done at our centre.
This article is for general information and does not replace a medical examination.
