What to Do If You Have Chest Pains

Most chest pain is not related to the heart. The following are clues that your chest pain is probably not caused by a heart problem:

When to Call Your Doctor

If you're not sure if your symptoms are serious or decide not to call 911, call our Consulting Nurse Service right away. They can help you decide if your pain is an emergency or not.

If you have chest pain that doesn't go away, you need to see your doctor for evaluation. Even chest pain that isn't caused by heart disease could be a warning sign of other problems in the aorta (the large blood vessel that leads out of the heart), the lungs, or digestive organs.

When to Call Your Doctor Immediately

Call your doctor right away if you have:

Let your doctor know if you have:

When to Call 911

Call 911 if you have heart attack symptoms that last longer than 5 minutes. Always seek emergency care right away if you think you're having a heart attack. Don't wait to see if it passes.

Don't drive yourself to the emergency room if you think you're having a heart attack. Call an ambulance or, if an ambulance can't come immediately, have someone drive you to the emergency room.

Call 911 or other emergency services if you have chest pain that is crushing or squeezing and comes with any of the following symptoms:

After calling 911 or other emergency services, chew and swallow 1 adult aspirin (325 milligrams), as long as you're not allergic to aspirin or unable to take it for some other reason.

Call 911 or other emergency services if you are caring for someone you think has had a heart attack. If the person is alert, he or she should chew and swallow 1 adult aspirin, as long as he or she is not allergic to aspirin or unable to take it for some other reason. If the person becomes unconscious and stops breathing, perform CPR.

Symptoms to Watch For

The symptoms of CAD and heart attack are different for different people. Some people might have chest pain. Others might have slight symptoms that could include breathlessness, heartburn, nausea, or fatigue. A heart attack might feel like severe indigestion that doesn't go away with antacids.

Most heart attacks involve some discomfort in the center of the chest that lasts more than a few minutes or that goes away and comes back.

Some ways to describe this discomfort are:

Lightheadedness, fainting, sweating, and shortness of breath can come with chest discomfort. People will usually have shortness of breath at the same time as chest pain, but it can also come before chest pain.

Chest pain can sometimes start in or spread to other areas of the upper body. This can include pain or discomfort in one or both arms (down the left arm is the most common site), the left shoulder, the mid-back, neck or lower jaw, and the stomach.

Additional symptoms of a heart attack include:

Heart Attack or Angina?

Chest pain from a heart attack lasts longer and is more severe than chest pain that is experienced with stable angina. Chest pain from angina usually begins at a low level and then gradually increases over several minutes to a peak. Stable angina usually goes away after 5 to 10 minutes or after taking nitroglycerin.

It's not always possible to tell the difference between unstable angina and a heart attack. Unstable angina is a change in the usual pattern of stable angina, such as chest pain that now happens at rest or with less and less exertion, or chest pain that's more severe or lasts longer.

When to Call Your Doctor

Call your doctor if you have any of the following:

Call 911 or other emergency services if you have CAD that has been diagnosed by a doctor and you have chest pain that doesn't go away after using your home treatment plan for angina.

When in Doubt

If you aren't sure if your symptoms are serious or decide not to call 911, call our Consulting Nurse Service right away. They can help you decide if your pain is an emergency or not.

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Clinical review by Art Resnick, MD
Group Health
Reviewed 03/01/2014