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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're under 40 years of age and otherwise well.
- New chest pain may signal serious heart issues. Heart problems are more likely if you smoke, have diabetes or high blood pressure, or are Māori, Pacific Peoples, or South Asian.
- Don’t try to diagnose yourself, you need to talk to a healthcare professional who can give you proper advice.
Chest pain means any pain, tightness or discomfort you feel in your chest area – from the level of your shoulders down to the bottom of your rib cage. It’s a common symptom and there may be many reasons for it.
Chest pain isn’t usually caused by heart problems, but it’s a good idea to see your healthcare provider to find out the reason for the pain, in case it’s something serious.
- lasts more than 10 minutes, or
- spreads to your arms, back, neck or jaw, or
- feels like crushing pain, heaviness, tightness or pressure in your chest, or
- is accompanied by nausea (feeling sick), sweating, dizzyness or shortness of breath.
You could be having a heart attack. Stop, rest and call 111 for an ambulance straight away as you need immediate treatment in hospital.
If you have angina medicine, stop, rest and take your angina medicine according to your action plan. If you still have symptoms after 10 minutes, treat it as a heart attack. Call 111 for an ambulance straight away.
- chest pain that comes and goes
- chest pain that goes away quickly but you're still worried.
Ring Healthline 0800 611 116 for advice if you don't know what to do.
DO NOT diagnose yourself from this information or any information you find on the internet. Also, don’t ask for advice from family or friends. You need to talk to a healthcare provider who can give you proper advice.
There are many causes of chest pain. Most of the time chest pain is not caused by heart problems, especially if you're 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:
- angina – chest pain that occurs when the blood supply to the muscles of your heart is restricted
- heart attack – blockage of one of the blood vessels supplying your heart
- pneumonia – a chest infection
- 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
- pneumothorax (collapsed lung) – air trapped in between your lung and chest wall
- ruptured oesophagus – a rare but serious tear in your food pipe that can happen after severe vomiting or medical procedures
- lung cancer or other cancers.
Other causes of chest pain include:
- heartburn, indigestion or gastroesophageal reflux disease (GORD)
- chest wall injury such as muscle strain or a bruised or broken rib
- stomach ulcer or peptic ulcer
- costochondritis – inflammation of joints in your chest
- anxiety or panic attack
- gallstones or pancreatitis (inflammation of the pancreas)
- shingles – a blistering skin rash with pain
- breast pain.
Sometimes it's not possible to identify the cause of chest pain, even 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 healthcare provider work out what's causing your chest pain.
Your healthcare provider will ask you questions about your chest pain and other symptoms you may have. This will help diagnose what's causing your chest pain.
Some of the questions your healthcare provider will ask about your chest pain include:
- Where is your chest pain?
- Did your chest pain start slowly or suddenly?
- Is there anything that makes the pain better or worse?
- How does your chest pain feel? Stabbing, burning, heaviness or tightness?
- Does your chest pain spread to other parts of your body?
Your healthcare provider will also ask you about your personal and family medical history to check if you have any risk factors that can increase your chance of getting heart disease. These include diabetes, high blood pressure, high cholesterol and existing heart conditions. Your age, gender, ethnicity and smoking behaviour can also affect your risk.
Your healthcare provider will examine your heart and lungs, including checking your blood pressure and pulse, and listening to your chest.
Depending on what they think is causing your chest pain, they may order some tests. These may include:
- blood tests to check for heart damage, clots, infection and inflammation
- 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 – an examination of your stomach lining using a thin flexible tube with a camera (endoscope) inserted down your throat and into your gut.
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
Also see the section above on when to get medical help.
Video: Chest pain – overview
(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?
(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
(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
(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022)
Video: Chest pain – when to see your GP
(Platform Trust, in partnership with Deafradio and Healthify He Puna Waiora, NZ, 2022)
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.
Heart attack warning signs(external link) Heart Foundation NZ
Chest pain – how to respond(external link) St John | Hato Hone, NZ
Chest pain(external link) NHS, UK
Chest pain(external link) Patient Info, UK
Chest pain(external link) HealthDirect, Australia
References
- Chest pain(external link) Auckland Regional HealthPathways, NZ, 2020
- Recent-onset chest pain of suspected cardiac origin – assessment and diagnosis clinical guideline(external link) NICE Guidelines, UK, 2019
- Chest pain(external link) Patient Info, UK, 2023
Recent-onset chest pain of suspected cardiac origin – assessment and diagnosis clinical guideline(external link) NICE Guidelines, UK, 2016
Australian clinical guideline for diagnosing and managing acute coronary syndromes 2025(external link) National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand, Australia, 2025
Heart attack (for healthcare providers) Healthify He Puna Waiora, NZ, 2024
The immediate management of acute coronary syndromes in primary care(external link) BPAC, NZ, 2025
Management of stable angina pectoris(external link) BPAC, NZ 2024
Chest pain(external link) Patient Info Doctor, UK, 2024
Cardiovascular disease risk assessment and management(external link) Heart Foundation, NZ, 2018
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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.
Reviewed by: Dr Grace Lee, FRNZCGP and Clinical Educator
Last reviewed:
