Chest pain

What is chest pain?

Chest pain is a common symptom that can be frightening and unpleasant. The pain can be felt anywhere in the chest area from your shoulders to the bottom of your ribs.

There are many causes of chest pain. Despite tests in the emergency department, it can be difficult to find out the cause of chest pain. You did the right thing by coming to hospital. It is important to take chest pain seriously and have a doctor check you.

Symptoms

The symptoms vary depending on the cause.

If chest pain relates to your heart, you will feel it:

• anywhere in the chest area
• the neck
• jaw or arms.

The chest pain may be:

• sharp
• dull
• tearing
• burning
• or a pressure-like sensation.

Your pain may be worse when you move. Or worse when you take a deep breathe. Or it could be triggered by pressing on specific areas on your chest. Sometimes chest pain may have other symptoms associated with it such as:

• a fever
• cough
• breathing difficulties
• sweating
• belching.

Causes

There are many causes of chest pain.  Here are some examples of chest pain that prompt people to go to the emergency department:

• Heart attack – also called ischemia. The pain is due to lack of blood supply to the heart.
• Gastro-oesophageal reflux – known as heart burn.
• Pleurisy pain – related to the lung. It may also be caused by a lung puncture or a clot in the lung.
• Pericarditis – a non-severe pain caused by inflammation of the sac surrounding the heart.
• Strained chest wall muscle – due to heavy lifting or prolonged coughing.
• Costochondritis – an inflammation of the joints around the rib cage. This condition is not serious.
• Anxiety – a common cause of chest pain. Chest pain due to anxiety is called Da Costa's syndrome.

Treatment

The treatment depends on the cause of the chest pain. Your doctor will explain your options before you leave the emergency department. Sometimes chest pain gets better, and no definite cause is found.

While you were in the emergency department, you most likely had some tests. This could include an ECG (which is a tracing of your heart) and blood tests. These tests will help your doctor decide what they think caused your chest pain.

Your doctor may feel the cause could be your heart but that your risks are low, and you can go home. The doctor will refer you to a cardiologist to have more tests in the coming days or weeks.

Home care

Take care of yourself by:

• taking it easy and rest if you feel tired
• slowly increase your activity as you are able
• if you feel well, you can return to work or strenuous activity (including sex)
• letting your family or friends know that you have been to hospital with chest pain so they can watch out for you for the next few days
• booking an appointment to see your general practitioner (GP) in the next three to five days, even if you feel well, as your doctor may need to arrange further tests.

Reduce your risk

You can make changes today to improve your heart health and reduce your risk of having a heart attack.

Stop smoking – Call Quitline on 137 848 or visit https://www.icanquit.com.au for advice and support. Your GP can also offer support.

Regular exercise – Try to achieve moderate physical activity such as brisk walking for at least 30 minutes, five days a week. Add physical activity into each day. For example, cycle to work or get off the bus a stop early and walk.

Maintain a healthy diet – Limit your intake of saturated fat and don’t add salt to meals. Avoid pre-made meals high in salt. Aim for at least five portions of vegetables every day and two servings of oily fish a week. High-fibre foods can reduce cholesterol levels and help you feel full for longer.

Have regular check-ups – Visit your GP to make sure your blood pressure and cholesterol are at safe levels. Your doctor may recommend medication to help reduce your risk of heart attack.

It is important that you take prescribed medications as directed. Don’t stop your medications without talking to your doctor. Let your doctor know if you have any side effects from your medications. There may be other tablets that can help you.

What to expect

Seek medical help immediately if you have chest pain that is in the middle of your chest, is crushing or squeezing and comes with any of the following symptoms:

• pain that spreads to the neck, jaw, or one or both shoulders or arms
• sweating
• shortness of breath
• nausea or vomiting
• dizziness or light-headedness
• fast or irregular pulse.

Seeking help

In a medical emergency call an ambulance – dial triple zero (000). Don’t drive yourself to hospital. Sit or lie down and rest while you wait for the ambulance.

If you have any concerns, see your local doctor or healthcare professional. If this is not possible return to the emergency department or urgent care centre.

For more information

Ask your local doctor or healthcare professional. You can also call healthdirect 24 hours a day on 1800 022 222 or visit healthdirect.gov.au.