Chest pain

Chest Pain: When Is It Dangerous?

Chest pain is one of the most alarming symptoms, as it is primarily associated with myocardial infarction. While cardiac causes are the most dangerous, it is important to know that chest pain can be caused by dozens of other, less threatening conditions related to the lungs, esophagus, muscles, or nerves. However, the main rule remains unchanged: any sudden, severe, or crushing chest pain is a reason to call emergency services immediately.

Cardiac (cardiovascular) causes of pain

This is the most dangerous group of causes that requires emergency care.

• Myocardial infarction: Occurs due to blockage of a coronary artery by a thrombus. Pain is usually described as intense, crushing, burning, feeling like a “pressure” behind the sternum. It may radiate to the left arm, neck, or jaw. It does not subside at rest.
• Angina: Pain similar to that of a heart attack but occurs during physical exertion or stress and resolves at rest or after taking nitroglycerin.
• Pericarditis: Inflammation of the pericardial sac. Pain is sharp, worsens with deep inhalation and when lying down.

Non‑cardiac causes of chest pain

These causes are much more common.

• Gastrointestinal problems: Severe acid reflux (heartburn) or esophageal spasm can mimic heart pain.
• Musculoskeletal problems: Muscle pain of the chest wall, inflammation of the costal cartilages (costochondritis) or nerve pinching. The pain usually worsens when pressure is applied to a specific point.
• Pulmonary problems: Pneumonia, pleuritis (inflammation of the lung lining) cause pain associated with breathing and coughing. Pulmonary artery thromboembolism (PATE) is a dangerous condition accompanied by sharp pain and shortness of breath.
• Psychogenic causes: A panic attack may be accompanied by severe chest pain, fear of death, and rapid heartbeat.