The most thought of association with chest pain is heart disease, in particular a heart attack. However, there are many other causes of it that are often seen such as gastro-oesophageal reflux disease (heartburn), Tietz syndrome (inflammation of the joints between the sternum and ribs) and lung-related causes. A common cause is musculoskeletal chest pain from protracted coughing.
Lung causes of it are usually related to pleurisy (inflammation of the lining of the lung). This type of pain is often made worse on inspiration and is sharp in nature. Causes of pleurtitic chest pain include: pulmonary emboli, infections (e.g. pneumonia) and systemic inflammatory conditions (e.g. Lupus).
If you have it and you think that you are having a heart attack you should call 999 for emergency medical assessment. For symptoms of a heart attack click here.
If your chest pain is pleurtic in nature (sharp pain that is worse on deep inspiration) associated with sudden onset of shortness of breath with or without associated fainting then urgent medical assessment is also required as it could be due to a pulmonary embolism.
Most other causes of chest pain don’t need emergency treatment but you should seek medical advice to establish a diagnosis and get treatment. For example, if it is due to a bacterial chest infection treatment with antibiotics will be required.
The clinical history often offers clues to the cause of it. Sometimes investigations are needed to either confirm or exclude potential causes.
Investigations may include:
Other tests may be needed and these will usually involve being assessed by a cardiologist or gastroenterologist.
Respiratory Medicine
Royal Brompton Hospital
Sydney Street
Chelsea
SW3 6NP
