You could be having a heart attack. Stop, rest and call 111 for an ambulance straight away as you need immediate treatment in hospital.
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See your GP if: |
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Chest pain
Key points about chest pain
- Chest pain means any pain, tightness or discomfort felt in your chest area.
- There are many causes of chest pain. Most of the time, it's not caused by heart problems, especially if you are younger than 40 and otherwise well.
- But chest pain can be a sign of something serious. If you have new symptoms of chest pain and you smoke, have high blood pressure, diabetes, high cholesterol or are more than 50 years old, you are more likely to have heart problems.
- Don’t try to diagnose yourself, you need to talk to a healthcare professional who can give you proper advice.
- Treatment will depend on what is causing your chest pain.
There are many causes of chest pain. Most of the time chest pain is not caused by heart problems, especially if you are younger than 40 and otherwise well. However, even mild chest tightness or discomfort can be the first sign of something more serious such as a heart attack or a blood clot in your lung.
Some of the more serious causes of chest pain caused by problems of your heart and lungs include:
- heart attack – blockage of one of the blood vessels supplying your heart
- angina – chest pain that occurs when the blood supply to the muscles of your heart is restricted
- pericarditis – inflammation of the lining around your heart
- aortic dissection – a tear in your main artery (the aorta)
- pulmonary embolus – a clot in one of the blood vessels in your lungs
- pneumonia – a chest infection
- pneumothorax (collapsed lung) – air trapped in between your lung and chest wall
- ruptured oesophagus – this can happen after retching, vomiting or medical procedures
- lung cancer or other cancers.
Other causes of chest pain include:
- heartburn, indigestion or gastroesophageal reflux disease (GORD)
- stomach ulcer or peptic ulcer
- gallstones or pancreatitis (inflammation of the pancreas)
- chest wall injury such as muscle strain or a bruised or broken rib
- costochondritis – inflammation of joints in your chest
- anxiety or panic attack
- shingles – a blistering skin rash with pain
- breast pain.
Sometimes it is not possible to identify the cause for chest pain after a thorough medical assessment. It may then be called ‘non-specific’ chest pain.
Chest pain is a broad term for any pain, tightness or discomfort felt in your chest area. Depending on the cause of your chest pain, it can start suddenly or slowly, and may spread to other areas such as your back, jaw, neck or arms. It can also be a sharp pain, stabbing pain or a heavy chest pain. You may also have other symptoms along with chest pain, which will help your doctor work out what is causing your chest pain.
Your doctor will ask you questions about your chest pain and other symptoms you may have. This will help diagnose what is causing your chest pain.
Some of the questions your doctor will ask about your chest pain include:
- Where is your chest pain?
- Did your chest pain start slowly or suddenly?
- Is there anything that will worsen or relieve your chest pain?
- How does your chest pain feel? Stabbing, burning, heaviness or tightness?
- Does your chest pain spread to other parts of your body?
Your doctor will also ask you about your past medical history and check if you have any risk factors that can increase your chance of getting heart disease, such as smoking, diabetes, high blood pressure, high cholesterol, or if you are older than 50 years.
Your doctor will examine your heart and lungs, including checking your blood pressure and pulse, and listening to your heart and lungs.
Depending on what your doctor thinks is causing your chest pain, they may order some tests. These may include:
- blood tests
- an electrocardiogram (ECG) to check the electrical activity of your heart
- an echocardiogram (echo) – an ultrasound scan of your heart to check your heart functioning
- a chest x-ray
- a coronary angiography – a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart
- a CT scan of blood vessels in your lungs (CTPA) to check for blood clots or of blood vessels in your heart (CT coronary angiogram)
- a gastroscopy – a thin flexible tube with camera inserted through your gut to examine your stomach lining.
The following links provide further information about chest pain. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
Chest pain(external link) Health New Zealand | Te Whatu Ora
Chest pain first aid(external link)(external link) HealthInfo Canterbury, NZ
Heart attack warning signs(external link)(external link) Heart Foundation NZ
Chest pain(external link)(external link) Mayo Clinic, US
Chest pain (beyond the basics information sheet)(external link)(external link) UpToDate, US
Chest pain(external link)(external link) NHS, UK
Chest pain(external link)(external link) Patient Info, UK
New Zealand Sign Language videos about chest pain, produced by Platform Trust, in partnership with Deafradio and Healthify NZ.
These videos are NZSL translations of Healthify pages on chest pain.
On this page, you can find NZSL videos about:
- Chest pain – overview
- What are the causes of chest pain?
- Other causes of chest pain
- Chest pain – when to text 111
- Chest pain – when to see your GP
Video: Chest pain – overview
This video may take a few moments to load.
(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022)
Read above for chest pain key points.
Video: What are the causes of chest pain?
This video may take a few moments to load.
(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022)
Read above for causes of chest pain.
Video: Other causes of chest pain
This video may take a few moments to load.
(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022)
Read above for other causes of chest pain.
Video: Chest pain – when to text 111
This video may take a few moments to load.
(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022)
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Text 111 immediately if you have chest pain that: |
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You could be having a heart attack. Stop, rest and text 111 for an ambulance straight away as you need immediate treatment in hospital.
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Video: Chest pain – when to see your GP
This video may take a few moments to load.
(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022)
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Contact your GP or health professional if: |
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References
- Chest pain(external link)(external link) Auckland Regional HealthPathways, NZ, 2020
- Recent-onset chest pain of suspected cardiac origin – assessment and diagnosis clinical guideline(external link)(external link) NICE Guidelines, UK, 2016
- Chest pain(external link)(external link) Patient Info, UK
Clinical guidelines
The following information about chest pain(external link) is taken from Auckland Regional HealthPathways, accessed March 2021:
Practice points
- Do an ECG for all but the most trivial chest pain
- Normal ECG does not exclude acute coronary syndrome
- In Māori or Pasifika patients, cardiovascular disease is more common and presents at a younger age.
Other clinical resources
Recent-onset chest pain of suspected cardiac origin – assessment and diagnosis clinical guideline(external link) NICE Guidelines, UK, 2016
National Heart Foundation of Australia & Cardiac Society of Australia and NZ – Australian clinical guidelines for the management of acute coronary syndromes 2016(external link) Heart, Lung and Circulation (2016) 25, 895–951.
Heart attack (for healthcare providers) Healthify He Puna Waiora, NZ, 2021
The immediate management of acute coronary syndromes in primary care(external link) BPAC, NZ, 2015
A follow-up to acute coronary syndromes(external link) BPAC, NZ, 2015
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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.
Reviewed by: Dr Alice Miller, FRNZCGP, Wellington
Last reviewed:
Page last updated:
