Chest Pain

Chest Pain - What it is

What is chest pain?

Man experiencing chest pain | SingHealth

Chest pain is a common presenting complaint of patients with coronary artery disease. Typical chest pain presents as a dull ache in the central chest which can last for several minutes (usually five to 15 minutes) and is aggravated by physical activity or emotional stress and relieved by rest. It can range from a dull ache to a sharp stabbing or pulling pain. For some patients, the pain can even spread to other body parts, such as the neck or jaw.

Various ailments can result in chest pain. While it may be caused by life-threatening conditions involving the heart or lungs, it can also arise from other disorders involving the gastrointestinal tract or muscular chest wall. As it may be difficult to determine the exact cause of chest pain, please seek immediate medical help for your chest pain concerns.

Chest Pain - Symptoms

What are the signs of chest pain related to heart conditions?

While chest discomfort is mostly associated with heart disease, it is difficult to correctly attribute the patient’s chest pain to a heart condition. Some general signs of chest pain related to a heart attack or other heart conditions include:

Shortness of breath
Cold sweats
Dizziness or fatigue
Nausea or vomiting
Pressure or tightness in your chest
A deep pain which radiates to your neck, jaw, back and arms — particularly on the left arm
Intermittent pain or pain which lasts for a while, especially becoming worse with exertion

Chest Pain - Causes and Risk Factors

What causes chest pain?

Chest pain can be also be due to digestive, heart or muscle and bone problems.

Some examples of heart-related causes of chest pain are:

Chest Pain - Diagnosis

How is chest pain diagnosed?

While chest pain is not always a symptom of a heart attack, it is important for doctors to test for this critical condition first. The doctor may also check for life-threatening lung conditions which may also present with chest pain.

Examples for initial diagnostic tests are:

Chest Pain - Treatments

How is chest pain treated?

The treatment for chest pain varies and is based on the underlying cause of your chest pain.

Other procedures and surgeries to treat some dangerous causes of chest pain include:

Balloons and stent placement
Bypass surgery
Dissection repair
Lung re-inflation

Chest Pain - Other Information

A common cause of chest pain is due to heart attack or a sudden cardiac arrest, two heart conditions with various differences.

Comparison between heart attack and cardiac arrest

Heart Attack	Cardiac Arrest
A heart attack occurs when there is a sudden obstruction of blood flow in the coronary artery. The part of the heart muscle which does not receive blood would be at risk of injury. Chest pain that lasts longer than 15 minutes and not relieved by rest might signal an impending heart attack. A heart attack can trigger life-threatening arrhythmia, leading to suddencardiac arrest.	Cardiac arrest occurs when there is a dangerous form of electrical malfunction in the heart. This causes the heart to pump ineffectively, resulting in the inability of vital organs to receive blood and oxygen. A person with sudden cardiac arrest might lose consciousness, collapse suddenly and become pulseless. Without emergency treatment, death usually ensues within minutes.
Symptoms The symptoms of a heart attack are typically more pronounced. Severe chest pain or discomfort lasting longer than 15 minutes New onset of chest pain or discomfort at rest or with minimal exertion Shortness of breath Cold sweat, nausea or light-headedness	Symptoms Sudden cardiac arrest often occurs without warning symptoms. Occasionally, short-lived warning symptoms might occur. Chest pain Heart palpitations Shortness of breath Light-headedness
What to do Requires immediate medical attention. Treatment may involve blood-thinning medication and coronary angioplasty (e.g. ballooning or stenting) to quickly unblock the affected coronary artery, allowing blood to flow. In some cases, coronary artery bypass surgery (CABG) may be required.	What to do Needs emergency treatment. In the first instance of sudden cardiac arrest, call 995 for an ambulance immediately. Perform cardiopulmonary resuscitation (CPR) and deliver treatment with automated external defibrillator (AED) while waiting for medical help to arrive. By doing so, it increases the person’s chances of survival.

Heart Attack

Cardiac Arrest

A heart attack occurs when there is a sudden obstruction of blood flow in the coronary artery. The part of the heart muscle which does not receive blood would be at risk of injury. Chest pain that lasts longer than 15 minutes and not relieved by rest might signal an impending heart attack. A heart attack can trigger life-threatening arrhythmia, leading to suddencardiac arrest.

Cardiac arrest occurs when there is a dangerous form of electrical malfunction in the heart. This causes the heart to pump ineffectively, resulting in the inability of vital organs to receive blood and oxygen. A person with sudden cardiac arrest might lose consciousness, collapse suddenly and become pulseless. Without emergency treatment, death usually ensues within minutes.

Symptoms

The symptoms of a heart attack are typically more pronounced.

Severe chest pain or discomfort lasting longer than 15 minutes
New onset of chest pain or discomfort at rest or with minimal exertion
Shortness of breath
Cold sweat, nausea or light-headedness

Symptoms

Sudden cardiac arrest often occurs without warning symptoms. Occasionally, short-lived warning symptoms might occur.

Chest pain
Heart palpitations
Shortness of breath
Light-headedness

What to do

Requires immediate medical attention. Treatment may involve blood-thinning medication and coronary angioplasty (e.g. ballooning or stenting) to quickly unblock the affected coronary artery, allowing blood to flow. In some cases, coronary artery bypass surgery (CABG) may be required.

What to do

Needs emergency treatment. In the first instance of sudden cardiac arrest, call 995 for an ambulance immediately. Perform cardiopulmonary resuscitation (CPR) and deliver treatment with automated external defibrillator (AED) while waiting for medical help to arrive. By doing so, it increases the person’s chances of survival.

References

Angina (chest pain). www.heart.org. (2024, October 14). https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain
Chest pain: A heart attack or something else? - harvard health publishing. Harvard Health. (2024, July 23). https://www.health.harvard.edu/heart-health/chest-pain-a-heart-attack-or-something-else
Arresting chest pains: A heart-stopping journey of VF and vasospastic angina. (2023). Graduate Medical Education Research Journal, 5(1). https://doi.org/10.32873/unmc.dc.gmerj.5.1.065

Overview

Cardiology,

Aortic Dissection,

Chest X-ray,

Computed Tomography (CT) Scan,

Coronary Artery Bypass Graft (CABG),

Coronary Artery Disease / Coronary Heart Disease,

Coronary Stent Implantation,

Electrocardiogram (ECG),

Heart Attack (Chest Pain),

Pericarditis,

Sudden Cardiac Arrest

Article contributed by Department of Cardiology, National Heart Centre Singapore

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

Clin Asst Prof Chan Lihua Laura

Senior Consultant

MBBS, MRCP (UK), M med (Int Med)

Clinical Interests: Heart Failure, Cardiac Magnetic Resonance Imaging

Clin Assoc Prof Chin Chee Tang

Senior Consultant

MBChB (Honours)(Edinburgh), MRCP(UK), FAMS

Clinical Interests: Interventional Cardiology

Clin Asst Prof Chin Chee Yang

Senior Consultant

MBChB, MRCP (UK), MSc in Clinical Education

ACSM Clinical Exercise Specialist

Clinical Interests: Interventional Cardiology

Assoc Prof Chin Woon Loong Calvin

Senior Consultant

MD, MRCP (UK), FAMS, FESC

Clinical Interests: Echocardiography, Cardiac Magnetic Resonance Imaging

Clin Assoc Prof Ching Chi Keong

Senior Consultant

MBBS, MRCP(UK), FAMS (Cardiology), FHRS

Clinical Interests: Electrophysiology ＆ Pacing

Clin Asst Prof Chong Thuan Tee Daniel

Head ＆ Senior Consultant

MBBS, MRCP(UK), FAMS

Clinical Interests: Electrophysiology ＆ Pacing

Prof Stuart Alexander Cook

Senior Consultant

MBBS, MRCP, PhD

Clinical Interests: Cardiac Magnetic Resonance Imaging

Clin Asst Prof Fam Jiang Ming

Senior Consultant

MBBS (Singapore), MRCP (UK), M Med (Int Med), FAMS, FACC, FESC, FASCC, Ph.D

Clinical Interests: Interventional Cardiology

Clin Asst Prof Go Yun Yun

Senior Consultant

MBBS (Singapore), MRCP (UK), MCI, FACC, FESC, FASE, FSCMR

Clinical Interests: Echocardiography, Cardiac Magnetic Resonance Imaging, Transesophageal Echocardiography, Transthoracic Echocardiography, Stress Echocardiography (Dobutamine and Bicycle Ergometer), Cardio-Oncology

Asst Prof Gunasegaran Kurugulasigamoney

Senior Consultant

MBBS, M Med (Int.Med)

Clinical Interests: Echocardiography

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