Chest pain — what might be happening and what you should do

Chest pain is scary. It can mean something serious like a heart attack, or something less dangerous like indigestion or a strained muscle. The trick is spotting the signs that need urgent care and knowing simple steps you can take while help arrives.

Red flags — call emergency services now

If someone has chest pain plus any of these, call emergency services immediately: pressure or squeezing in the center of the chest; pain spreading to the jaw, neck, shoulder, arm or back; sudden shortness of breath; fainting or near-fainting; cold sweat, nausea or lightheadedness. If symptoms come on suddenly during activity, or the person is pale and confused, don’t wait. Tell the dispatcher about the symptoms and follow their instructions.

If a dispatcher asks, and the person is conscious and not allergic, chewing one standard-strength aspirin (300 mg) can be helpful on the way to hospital — but only if emergency services advise it and the person isn’t on a blood thinner or has an aspirin allergy. Do not give nitroglycerin unless it was prescribed to that person and you know how to use it.

Common non-emergency causes and how to handle them

Many causes of chest pain aren’t life-threatening. Here are the most common ones and quick tips:

Acid reflux / heartburn: a burning sensation, often after eating, worse when lying down. Try an antacid, sit upright, and avoid big meals, coffee, alcohol and smoking. If reflux is frequent, mention Nexium or other acid-reducing options to your doctor.

Muscle or rib pain: sharp pain that gets worse with movement or pressing the chest. Rest, avoid heavy lifting, use a warm compress and, if safe for you, an over-the-counter pain reliever like ibuprofen. See a GP if pain doesn’t improve in a week.

Anxiety or panic attack: chest tightness with rapid heartbeat, sweating and fear. Slow deep breaths, sit down, and try grounding techniques. If this is a new symptom, check with a doctor to rule out heart causes.

Respiratory causes: pneumonia or a blood clot in the lung (pulmonary embolism) can cause sharp, stabbing chest pain and breathlessness. These need medical review—especially if you’re coughing up blood or the breathlessness is sudden.

Cardiac chest pain (angina): pressure, tightness or squeezing that comes with exertion and eases with rest. This warrants urgent medical testing even if it settles—angina often signals narrowing of the heart arteries.

What tests might a doctor order? An ECG, blood tests for heart muscle markers (troponin), chest X-ray, and sometimes CT scans or endoscopy if reflux or lung causes are suspected. Treatment depends on the cause—ranging from lifestyle changes and medication to urgent heart procedures.

If you’re unsure what’s causing your chest pain, err on the side of caution: seek medical help. It’s better to get checked and be reassured than to miss a serious problem. Keep a note of when the pain started, what you were doing, how long it lasts, and any other symptoms—that helps clinicians act fast.