Chest pain is a common symptom and can arise from many different causes. While it is often associated with heart disease, not all chest pain is cardiac in origin.
People may describe chest pain in different ways, including pressure, heaviness, burning, sharp discomfort, or tightness. The quality, duration, and triggers of symptoms provide important clues about possible causes of chest pain.
The purpose of cardiac assessment is to determine whether symptoms are related to reduced blood flow to the heart, another cardiac condition, or a non-cardiac source such as musculoskeletal or gastrointestinal causes.
Chest pain causes can broadly be grouped into cardiac and non-cardiac categories.
Cardiac causes may include coronary artery disease, coronary artery spasm, or other structural conditions. Non-cardiac causes are common and may include reflux, muscle strain, inflammation of the chest wall, anxiety, or lung conditions.
Features that guide assessment include:
Many people referred for chest pain are ultimately found not to have significant coronary disease. However, careful evaluation is important to avoid both missed diagnoses and unnecessary investigations.
Some patterns of chest pain require urgent medical assessment.
Seek immediate medical attention if chest pain is:
This page provides general information only and does not replace emergency care. If symptoms are severe or worsening, urgent assessment is essential.
Assessment begins with a detailed clinical history and physical examination. Understanding the context and pattern of symptoms is central to determining next steps.
Investigations may include ECG testing, blood tests, stress testing, echocardiography, or coronary imaging, where appropriate. Testing is guided by clinical suspicion rather than performed routinely.
Normal results are often reassuring. They help clarify that symptoms are not related to significant structural or obstructive heart disease and can reduce ongoing uncertainty.
Not all chest pain requires invasive testing. Equally, persistent or exertional symptoms should not be dismissed.
Management depends on the cause identified. This may include medication, lifestyle modification, monitoring, or reassurance. In some cases, further investigation, such as coronary imaging, may be appropriate.
The aim of care is to provide clarity, avoid unnecessary medicalisation, and ensure that significant cardiac conditions are identified and managed appropriately.
