Types of Chest Pain

Edited by Michelle Asselin



Chest pain can be extremely scary, especially if is the first time experiencing it. Many people associate chest pain with a problematic heart condition, but chest pain may have many different origins, some of which do not involve the heart. About 25% of people experience some form of chest pain at least once in their lifetime. Recognizing the different types of chest pain and knowing when to seek emergency medical attention may be life-saving.



Common Types of Chest Pain


Chest pain can be caused by conditions that affect the heart, abdomen, lungs, stomach, intestines, bones, or muscles.



Cardiac Chest Pain


Pain associated with the heart is usually triggered by physical exertion, exercise, emotional distress, extreme temperatures, or eating. The pain usually feels like a squeezing, pressurized and heavy sensation in the front of the chest. This pain may radiate to the jaw, arms, neck, and back. Pain is generally not worsened by applying physical pressure to the area and lasts about 2-5 minutes but can persist for up to 10 minutes. Changing positions and trying to move may worsen the pain, while resting may relieve the pain.


Cardiac chest pain can be due to many different medical conditions, such as angina, heart infections, heart inflammations, pulmonary hypertension, and pulmonary embolisms. If you are experiencing any of the above symptoms, it is essential to see your doctor as soon as possible to get a full workup done, which may include an echocardiogram, or an ultrasound of the heart.



Stomach/Esophageal-Associated Chest Pain


Pain associated with the stomach or intestines can be felt in the chest, especially if this pain is quite severe. This pain is typically due to stomach inflammation or indigestion. This pain presents as a burning sensation that starts in the stomach and may travel up to the esophagus, or the back of the throat. This pain is worsened by food but may be relieved by heartburn medications such as Tums.



Muscle and Bone-Associated Chest Pain


Pain due to a fracture or muscle trauma in the abdominal area can also be associated with chest pain. This pain usually presents as a sore, achy, or sharp pain in the injured area. Movement usually makes this pain worse, while rest and heat may make the pain better.



Asthma, COPD, or Other Respiratory Conditions


Conditions that affect breathing can strain the lungs, and this may often be associated with chest pain. This pain usually presents as a heavy, pressurizing sensation in the chest, and is usually worsened by attempting to take a deep breath. Reliever inhalers, such as Ventolin or Symbicort, may be needed to help relieve the pain and allow for the individual to draw up a full breath.



This list is not all-inclusive, and only includes the more common causes of chest pain.



When to Call 911


Call 911 immediately if you experience sudden chest pain or heaviness, sweating, upper body discomfort, nausea, shortness of breath, light headedness, or chest pain that radiates to the jaw, neck, shoulder, arms, or back. These may be signs of a heart attack. Emergency services may be able to provide you with early treatment that can be lifesaving. Do not attempt to drive yourself to the hospital.


It is important to note that many studies have identified that there may be a difference in heart attack symptoms between men and women. Men are more likely to experience “classic” heart attack symptoms, such as chest pain and other symptoms described above. In contrast, women are less likely to experience sharp chest pain radiating to the arm or neck and are more likely to experience some of the more uncommon symptoms, such as nausea, vomiting, back pain, dizziness, and heart palpitations.


If your doctor or pharmacist has provided you with rescue nitroglycerin spray, spray one dose under the tongue at the first sign of chest pain. You may repeat a dose of the spray in 5-10 minutes, if needed. If the pain gets worse or does not improve after the first dose, call 911 and continue taking the spray every 5 minutes until emergency services arrives.


Once you have called 911, chew and swallow two low-dose aspirin tablets (81mg). Aspirin prevents blood clots from forming which may cause damage to the heart, thereby increasing the chances of survival.


If you experience chest pain, it is important to see a doctor to identify the cause of the chest pain. You may also be provided with medications that may help in relieving the pain, and education specific to the cause of your chest pain.



 


References

  1. Geyser M, Smith S. Chest pain prevalence, causes, and disposition in the emergency department of a regional hospital in Pretoria. 2016, 8(1): 1048. DOI: 10.4102/phcfm.v8i1.1048

  2. Heart and Stroke Foundation. Emergency Signs: When to call 9-1-1. Updated 2022. Accessed February 15, 2022. https://www.heartandstroke.ca/heart-disease/emergency-signs/heart-attack-and-stroke

  3. Pham CQ. Dyspepsia and GERD. In: Compendium of Therapeutics for Minor Ailments. Canadian Pharmacists Association. Updates September 27, 2018. Accessed February 15, 2022. https://www-e-therapeutics-ca.login.ezproxy.library.ualberta.ca/search

  4. Berg J, Bjorck L, Dudas K, Lappas G, Rosengren A. Symptoms of a first acute myocardial infarction in women and men. Gender Medicine. 6(3): 454-462. Published September 2009. https://doi.org/10.1016/j.genm.2009.09.007

  5. Nitroglycerin. In: Lexi-Drugs. Lexi-Comp, Inc. Updated December 20, 2019. Accessed March 7, 2022. http://online.lexi.com.

  6. Aspirin. In: Lexi-Drugs. Lexi-Comp, Inc. Updated February 21, 2022. Accessed February 22, 2022. http://online.lexi.com.

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