Symptom · Chest
Chest pain
Also known as: chest tightness, angina
Pain or pressure anywhere between the neck and the upper abdomen. The chest holds the heart, lungs, oesophagus, great vessels, ribs and muscles, and pain from any of them can feel similar, which is why chest pain is assessed urgently until a heart or lung cause is excluded.
What it is
Pain or pressure anywhere between the neck and the upper abdomen. The chest holds the heart, lungs, oesophagus, great vessels, ribs and muscles, and pain from any of them can feel similar, which is why chest pain is assessed urgently until a heart or lung cause is excluded.
Common causes
Musculoskeletal painStrained chest muscles or inflamed rib cartilage (costochondritis): sharp, localised, worse on pressing or moving.
Acid reflux and oesophageal spasmBurning behind the breastbone after meals or lying flat, often with acid taste.
Anxiety and panicTightness with rapid breathing, tingling and a racing heart; a diagnosis made only after other causes are excluded.
AnginaHeavy, squeezing pressure on exertion or stress, relieved by rest, from narrowed coronary arteries.
Chest infection and pleurisySharp pain on breathing in, with cough or fever.
Less common causes
Heart attack (myocardial infarction)Crushing central pain spreading to the arm, jaw or back with sweating, nausea and breathlessness; may be silent in diabetes and the elderly.
Pulmonary embolismSudden sharp pain with breathlessness, sometimes coughing blood, often with a swollen leg.
Aortic dissectionTearing pain radiating to the back, often with very high blood pressure.
PneumothoraxSudden one-sided pain and breathlessness, especially in tall young men or lung disease.
PericarditisSharp pain eased by sitting forward, worse lying back.
Often occurs with
Seek urgent care if
- Central chest pressure lasting more than a few minutes, or spreading to the arm, jaw or back, especially with sweating, nausea or breathlessness: call emergency services
- Chest pain with sudden breathlessness, coughing blood or a swollen painful leg
- Tearing pain radiating to the back
- Chest pain with fainting, a very fast or irregular pulse, or blue lips
Conditions to read about
Coronary artery diseaseHeart attack (myocardial infarction)Pulmonary embolismGastro-oesophageal reflux diseasePneumonia
How it is investigated
Educational content. This page explains what a symptom can mean so that the anatomy and the medical reasoning make sense. It cannot tell you what is causing yours: only a clinician who can examine you and order tests can do that.