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Chest Problems
Topic Overview
Chest pain and heart attack
Chest discomfort or pain may be a key warning symptom of a heart attack. Heart attack symptoms may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
Chest discomfort or pain that comes on or gets worse with exercise, stress, or eating a large meal and goes away with rest may also be a symptom of heart disease called angina.
If you have any of these symptoms of a heart attack, call 911 or other emergency services immediately. After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself. Since most of the damage to the heart muscle during a heart attack occurs in the first 6 hours, emergency treatment may prevent damage to the heart muscle and death. For men and women, the most common symptom is chest pain or pressure. Women are somewhat more likely than men to have other symptoms like shortness of breath, nausea, and back or jaw pain.
Other causes of chest discomfort or pain
Most people fear that chest pain always means that something is wrong with the heart. This is not the case. Chest discomfort or pain, especially in people who are younger than age 40, can have many causes.
- Angina (say “ANN-juh-nuh” or “ann-JY-nuh”) is a type of chest pain or discomfort that happens when there is not enough blood flow to the heart muscle. Angina is a symptom of coronary artery disease, also called heart disease. Angina is called stable angina when you can usually predict when your symptoms will happen. You probably know what things cause your angina. A sudden and unexpected change in your usual pattern of angina means that the blood flow has become more impaired and you could be having a heart attack. This is called unstable angina.
- Pain in the muscles or bones of the chest often occurs when you increase your activities or add exercise to your schedule. This is sometimes called chest wall pain.
- Costochondritis is an inflammation of the joints formed by the cartilage connecting the ribs to the breastbone (sternum). The inflammation could be caused by an injury to the chest, but often the reason for the inflammation is not known.
- Burning chest pain that occurs when you cough may be caused by an upper respiratory infection caused by a virus.
- Burning chest or rib pain, especially just before a rash appears, may be caused by shingles.
- An injury such as a broken rib or bruised lung can be quite painful, especially when you cough or try to take a deep breath.
- Swelling (inflammation) of the thin layers of tissue (pleura) covering the lungs and the chest wall may occur. This is called pleurisy.
- Gastroesophageal reflux disease (GERD) can cause pain just below the breastbone. Many people will say they have “heartburn.” This pain is usually relieved by taking an antacid or eating.
Other, more serious problems that can cause chest pain include:
- An infection, such as pneumonia.
- A collapsed lung (pneumothorax), which usually causes a sharp, stabbing chest pain and occurs with shortness of breath.
- A blood clot in the lung (pulmonary embolism), which usually causes deep chest pain with the rapid development of extreme shortness of breath.
- Lung cancer, which may cause chest pain, especially if the cancer cells spread to involve the ribs.
- Diseases of the spine, which can cause chest pain if the nerves in the spine are “pinched.”
Check your symptoms to decide if and when you should see a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Severe trouble breathing means:
- You cannot talk at all.
- You have to work very hard to breathe.
- You feel like you can’t get enough air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means:
- It’s hard to talk in full sentences.
- It’s hard to breathe with activity.
Mild trouble breathing means:
- You feel a little out of breath but can still talk.
- It’s becoming hard to breathe with activity.
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Adults and older children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Feeling very dizzy or lightheaded, like you may pass out.
- Feeling very weak or having trouble standing.
- Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Babies and young children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Being very sleepy or hard to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused. The child may not know where he or she is.
Symptoms of a heart attack may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that you’re having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don’t have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don’t have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Call 911 Now
Based on your answers, you need emergency care.
Call911or other emergency services now.
Call 911 Now
Based on your answers, you need emergency care.
Call911or other emergency services now.
After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Home Treatment
Home treatment is not appropriate for chest pain if the pain occurs with symptoms of a heart attack. If you think a heart attack might be the cause of your symptoms, call 911 or other emergency services immediately. After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
Home treatment for people who have been diagnosed with chest pain (angina)
If you have stable angina, you can probably predict when your symptoms will happen. You probably know what things cause your angina. If you and your doctor have made a home treatment plan, follow that plan. If you are having angina symptoms more often than usual or if they are different or worse than usual, call your doctor right away. If you have angina symptoms that do not go away with rest or are not getting better within 5 minutes after you take a dose of nitroglycerin, call 911 or other emergency services immediately.
You may be able to control how much your angina bothers you by making changes in your lifestyle. You may find it helpful to:
- Avoid strenuous activities that bring on angina.
- Eat balanced, nutritious meals. Try to limit the amount of fats and fatty foods you eat.
- Maintain a healthy weight.
- Limit the amount of alcohol you drink. Don’t drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman.
- Do not smoke or use other tobacco products. For more information, see the topic Quitting Smoking.
- Reduce stress. For more information, see the topic Stress Management.
- Control your blood pressure with diet and medicine. For more information, see the topic High Blood Pressure.
- Avoid extremely cold or hot environments.
- Take all medicines, such as nitroglycerin, as instructed by your doctor.
- Follow the exercise or activity program you and your doctor developed.
If you do not need 911 emergency medical treatment for your chest pain or angina, take your pulse before reporting your symptoms to your doctor. Your heart rate and rhythm at the time of your chest pain may help your doctor evaluate your symptoms.
Home treatment for minor pain in the chest
Home treatment for minor chest pain depends on the cause of the pain. Minor chest pain often improves with home treatment. A visit to your doctor may not be needed.
Chest wall pain
For chest wall pain caused by strained muscles or ligaments or a fractured rib:
- Rest. Rest and protect an injured or sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
- Ice. Cold will reduce pain and swelling. Apply an ice or cold pack immediately to prevent or minimize swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day. After 48 to 72 hours, if swelling is gone, apply warmthto the area that hurts.
- Do not wrap or tape your ribs for support. This may cause you to take smaller breaths, which could increase your risk for developing pneumonia or partial lung collapse (atelectasis).
- Medicated creams that you put on the skin (topical) may soothe sore muscles.
- Gentle stretching and massage may help you get better faster. Stretch slowly to the point just before discomfort begins, then hold the stretch for 30 to 60 seconds. Do this 3 to 4 times a day. It is really helpful after the use of heat.
- As your pain gets better, slowly return to your normal activities. Any increased pain may mean that you need to rest a while longer.
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Try a nonprescription medicine to help treat your fever or pain: |
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Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine. |
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Be sure to follow these safety tips when you use a nonprescription medicine: |
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If you have other symptoms along with your minor chest pain, see the Related Information section for topics that relate to your other symptoms.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- You have increased difficulty breathing.
- Chest discomfort lasts longer than 1 week.
- Symptoms become more severe or frequent.
Prevention
The following tips may prevent chest problems or injuries.
- Stay in good overall physical shape. Do stretching and range-of-motion (ROM) exercises for your arms and shoulders.
- Maintain good posture. Stand straight and relaxed, without slumping.
- Warm up well and stretch before any activity.
- Wear protective gear during contact sports or recreational activities, such as hockey or football.
- Wear your seat belt when in a motor vehicle.
- Make sure your child’s backpack is the right size with good support. Carrying heavy backpacks may increase his or her risk of chest problems or injury.
Preparing For Your Appointment
To prepare for your appointment, see the topicMaking the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- When did the chest pain begin?
- How long does the pain last?
- How often does the pain occur?
- How severe is the pain?
- What does the pain feel like?
- Where is the pain located?
- Does the pain change or get worse when you take a deep breath?
- What were you doing when it started? Is the pain related to activity? Is it related to eating? Is it related to body position?
- Does the pain start in the chest and spread to another part of the body? Or does it start somewhere else and spread to the chest?
- Did you have other symptoms with the chest pain? What are the other symptoms?
- Has this ever happened before? If so, did you see a doctor?
- What was the diagnosis?
- What tests were done?
- How was it treated?
- Have you had a chest injury or a fall?
- How and when did an injury occur?
- Have you had any chest injuries in the past? Do you have any continuing problems because of the previous injury?
- What activities make your symptoms better or worse?
- What home treatment have you tried to relieve the pain? Did it help?
- What nonprescription medicines have you taken? Did they help?
- Do you have any health risks?
Current as of: June 26, 2019
Author: Healthwise Staff
Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine
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