Chest Pain

Also known as: Pain, chest

Providence Heart and Vascular Institute comprises more than 80 highly-skilled physicians and surgeons. Each year at the Institute, more than 13,000 patients benefit from the latest advances in diagnosis, treatment and cardiac surgery.

Providence Pulmonary and Critical Care Medicine provides inpatient and outpatient consultation, evaluation and state-of-the-art treatment for a wide range of acute and chronic lung diseases and critical illnesses.

Chest Pain

Problem

Is this your symptom?

  • Uncomfortable pressure, fullness, squeezing, or other pain in the chest

  • This includes the area from the collar-bone to the bottom of the rib cage

What to Do

Select the First Symptom that Applies

Call 911 Now

  • Passed out (fainted)

  • Very weak (can't stand)

  • Sweat on or dripping down face

  • Severe trouble breathing (struggling for each breath or can't speak)

  • Lips or face are blue

  • Severe chest pain

  • Chest pain lasting more than 5 minutes and any of these:

    • Pain is crushing, pressure-like, or heavy

    • History of heart disease (angina, heart attack, bypass surgery, angioplasty)

    • Over 50 years old

    • Over 30 years old and have one or more cardiac risk factors (high blood pressure, diabetes, high cholesterol, obesity, smoker, or strong family history of heart disease)

  • Took nitroglycerin and chest pain did not go away

  • You think you have a life-threatening emergency

Go to ER Now

  • Chest pain lasts more than 5 minutes

  • Chest pain brought on by activity and made better by rest

  • Chest pain spreads into shoulder, arm, or jaw

  • Angina chest pain and it has been getting worse or more frequent

  • Trouble breathing or taking a breath makes pain worse

  • Coughing up blood

  • Feeling dizzy, lightheaded, or weak

  • Heart beat is not normal or is very fast

  • Prior blood clot in legs or lungs (often treated with a blood thinner like heparin or Coumadin)

  • Major surgery within past two months

  • Hip or leg fracture within past two months

  • Long distance travel within last month (trip lasting 6 or more hours in a car, bus, plane, or train)

  • Bedridden within last month (nursing home patient, stroke, chronic illness, or recovering from surgery)

  • Cocaine use

Call Doctor Now or Go to ER

  • Fever

  • You feel weak or very sick

  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Rash or small blisters in same area as pain

  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Chest pain that comes and goes for a few seconds each time, and lasts more than 3 days

  • Chest pain only when coughing, and lasts more than 3 days

  • You have other questions or concerns

Self Care at Home

  • Chest pains come and go for a few seconds each time

  • Mild chest pain only when coughing

Care Advice

Mild Chest Pain

  1. What You Should Know:

    • Not all chest pain is serious. But it is safer to assume that your chest pain is serious until you see a doctor.

    • Pain felt in the chest can come from things besides the heart. The ribs, spine, lungs, and other organs in the upper abdomen can also cause chest pain.

    • You can treat mild chest pain at home.

    • Here is some care advice that should help.

  2. Fleeting Chest Pain: These pains last only a few seconds and then go away. They are usually not serious. They may be from pinched muscles or nerves in your chest wall.

  3. Chest Pain Only When Coughing: Pain comes from the chest wall and airway irritation. This pain is most often not serious.

  4. Cough Medicines:

    • Over-the-Counter (OTC) Cough Syrups: Some people find that cough syrups help decrease coughing. Dextromethorphan is the most common cough suppressant in OTC cough syrups. Often the letters "DM" appear in the name.

    • OTC Cough Drops: Cough drops can help a lot. They work best for mild coughs. They soothe the tickling feeling in the back of the throat. Cough drops are easy to carry with you.

    • Home Remedy - Hard Candy: Hard candy works just as well as OTC cough drops. Diabetics should use sugar-free candy.

    • Home Remedy - Honey: Honey has been shown to help decrease coughing at night. The adult dose is 2 teaspoons (10 ml) at bedtime.

  5. What to Expect: These mild chest pains most often go away within 3 days.

  6. Call Your Doctor If:

    • Severe chest pain

    • Constant chest pain lasts more than 5 minutes

    • Trouble breathing occurs

    • Fever occurs

    • You think you need to be seen

    • You get worse

Internet Resources

  1. Heart Attack Symptoms and Warning Signs:

    • The American Heart Association has helpful information about heart attack, stroke, and other diseases.

    • You can find this online at: http://www.heart.org/

  2. Women and Heart Disease: 

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Causes and Background Information

Some Basics...

  • Not all chest pain is serious. But it is safer to assume that chest pain is serious until seen by a doctor.

  • Serious causes of chest pain include angina, aortic dissection (tear in aorta), myocardial infarction (heart attack), pericarditis (inflammation of heart), pneumonia, and pneumothorax (collapsed lung).

  • Less serious cause of chest pain include costochondritis (arthritis of ribs), gastro-esophageal reflux (GERD or acid reflux), and muscle strain.

  • Pain felt in the chest can come from things besides the heart. The ribs, spine, lungs, and other organs in the upper abdomen can also cause chest pain.

Pain Scale

  • None: No pain. Pain score is 0 on a scale of 0 to 10.

  • Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.

  • Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.

  • Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

What Are the Symptoms of a Heart Attack?

  • Chest pain or discomfort: This is normally felt in the center of the chest. It may feel like pressure, squeezing, or heaviness. It lasts for more than a few minutes.

  • Upper body pain or discomfort: Felt in the upper arms, jaw, neck, or back.

  • Shortness of breath

  • Other symptoms: These can include sweating more than normal, nausea, and feeling lightheaded.

If you think you are having a heart attack, call 911 (an ambulance) right away!

Images

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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.