Chest Problems

Topic Overview

Chest pain and heart attack

Chest discomfort or pain is a key warning symptom of a heart attack. Heart attack symptoms include:

  • Chest discomfort or pain that is crushing or squeezing or feels like a heavy weight on the chest.
  • Chest discomfort or pain that occurs with:
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or uneven heartbeat.

If you have any of these symptoms of a heart attack, call 911 or other emergency services immediately. Since most of the damage to the heart muscle during a heart attack occurs in the first 6 hours, emergency treatment may prevent damage to the heart muscle and death. Some people, especially those who are elderly or have diabetes, may not have typical chest pain but may have many of the other symptoms of a heart attack. Women are more likely than men to have neck and shoulder pain along with other symptoms.

Chest discomfort or pain that comes on or gets worse with exercise, stress, or eating a large meal and goes away with rest may be a warning symptom of heart disease. If you are having this type of discomfort or pain now and you are not being treated for angina, call 911 or other emergency services immediately.

Other causes of chest discomfort or pain

Most people fear that chest pain always means something is wrong with the heart. This is not the case. Chest discomfort or pain, especially in people who are younger than age 40, can have many causes.

  • Pain in the muscles or bones of the chest often occurs when you increase your activities or add exercise to your schedule. This is sometimes called chest wall pain.
  • Burning chest pain that occurs when you cough may be caused by an upper respiratory infection caused by a virus.
  • Burning chest or rib pain, especially just before a rash appears, may be caused by shingles.
  • A broken rib can be quite painful, especially when you cough or try to take a deep breath.
  • Gastroesophageal reflux disease (GERD) can cause pain just below the breastbone. Many people will say they have "heartburn." This pain is usually relieved by taking an antacid or eating.

Other, more serious problems that can cause chest pain include:

  • A collapsed lung (pneumothorax), which usually causes a sharp, stabbing chest pain and occurs with shortness of breath.
  • A blood clot in the lung (pulmonary embolism), which usually causes deep chest pain with the rapid development of extreme shortness of breath.
  • Lung cancer , which may cause chest pain, especially if the cancer cells spread to involve the ribs.
  • Diseases of the spine, which can cause chest pain if the nerves in the spine are "pinched."

Use the Check Your Symptoms section to decide if and when you should see a doctor.

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Check Your Symptoms

Home Treatment

Home treatment is not appropriate for chest pain if the pain occurs with symptoms of a heart attack. If you think a heart attack might be the cause of your symptoms, call 911 or other emergency services immediately.

Home treatment for people who have been diagnosed with chest pain (angina)

Most people who have been diagnosed with angina have a pattern to their angina attacks that they can recognize. If you and your doctor have made a home treatment plan for your angina attacks, follow that plan. If the pain gets worse or does not go away or if you are unsure how to use your plan, call 911 or other emergency services immediately.

You may be able to control how much your angina bothers you by making changes in your lifestyle. You may find it helpful to:

  • Avoid strenuous activities that bring on angina.
  • Eat balanced, nutritious meals. Try to limit the amount of fats and fatty foods you eat.
  • Maintain a healthy weight.
  • Limit the amount of alcohol you drink. Safe amounts are less than 2 drinks a day for men and 1 drink a day for women. One drink is 12 fl oz (360 mL) of beer, 5 fl oz (150 mL) of wine, or 1.5 fl oz (45 mL) of hard liquor. Do not drink every day.
  • Do not smoke or use other tobacco products. See Click here to view an Actionset.Quitting Smoking.
  • Reduce stress. For more information, see the topic Stress Management.
  • Control your blood pressure with diet and medicine. For more information, see the topic High Blood Pressure (Hypertension).
  • Avoid extremely cold or hot environments.
  • Take all medicines as instructed by your doctor.
  • Follow the exercise or activity program you and your doctor developed.

If you do not need 911 emergency medical treatment for your chest pain or angina, take your pulse before reporting your symptoms to your doctor. Your heart rate and rhythm at the time of your chest pain may help your doctor evaluate your symptoms.

Home treatment for minor pain in the chest

Home treatment for minor chest pain depends on the cause of the pain. Minor chest pain often improves with home treatment. A visit to your health professional may not be needed.

Chest wall pain

For chest wall pain caused by strained muscles or ligaments or a fractured rib:

  • Rest. Rest and protect an injured or sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
  • Ice. Cold will reduce pain and swelling. Apply an ice or cold pack immediately to prevent or minimize swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day. After 48 to 72 hours, if swelling is gone, apply warmth to the area that hurts.
  • Do not wrap or tape your ribs for support. This may cause you to take smaller breaths, which could increase your risk for developing pneumonia or partial lung collapse (atelectasis).
  • Medicated creams that you put on the skin (topical) may soothe sore muscles.
  • Gentle stretching and massage may help you get better faster. Stretch slowly to the point just before discomfort begins, then hold the stretch for 30 to 60 seconds. Do this 3 to 4 times a day. It is really helpful after the use of heat.
  • As your pain gets better, slowly return to your normal activities. Any increased pain may mean that you need to rest a while longer.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

If you have other symptoms along with your minor chest pain, see the Related Information section for topics that relate to your other symptoms. Review the Home Treatment sections for those symptoms.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

  • You have increased difficulty breathing.
  • Chest pain is not relieved by home treatment.
  • Chest pain lasts longer than 1 week.
  • Chronic pain has become worse or other symptoms have developed with the pain.
  • Symptoms become more severe or frequent.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

  • When did the chest pain begin?
    • How long does the pain last?
    • How often does the pain occur?
    • How severe is the pain?
    • What does the pain feel like?
    • Where is the pain located?
  • What were you doing when it started? Is the pain related to activity? Is it related to eating? Is it related to body position?
  • Does the pain start in the chest and spread to another part of the body? Or does it start somewhere else and spread to the chest?
  • Did you have other symptoms with the chest pain? What are the other symptoms?
  • Has this ever happened before? If so, did you see a doctor?
    • What was the diagnosis?
    • What tests were done?
    • How was it treated?
  • Have you had a chest injury or a fall?
    • How and when did an injury occur?
    • Have you had any chest injuries in the past? Do you have any continuing problems because of the previous injury?
  • What activities make your symptoms better or worse?
  • What home treatment have you tried to relieve the pain? Did it help?
  • What nonprescription medicines have you taken? Did they help?
  • Do you have any health risks?

Credits

Author Jan Nissl, RN, BS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Tracy Landauer
Primary Medical Reviewer Steven L. Schneider, MD - Family Medicine
Primary Medical Reviewer William M. Green, MD - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Specialist Medical Reviewer Adam Husney, MD - Family Medicine
Last Updated April 24, 2009

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