Chest Pain or Pressure: When to Worry and What to Do

Red flags and urgency levels

• EmergencyCall 911 or go to an emergency department now

  Crushing, squeezing or heavy chest pressure lasting more than a few minutes, or pain spreading to the arm, jaw, neck or back.

• EmergencyCall 911 or go to an emergency department now

  Chest pain with shortness of breath, cold sweat, nausea, fainting, or a sense of doom.

• UrgentSeek care today

  New chest discomfort brought on by exertion and relieved by rest, even if mild.

• SoonMake an appointment within days to a couple of weeks

  Recurrent burning chest discomfort after meals or when lying down.

• MonitorKeep track and mention it at your next visit

  Brief, sharp pain that is reproducible when you press on the chest wall or change position.

• Cardiac causes (such as reduced blood flow to the heart) are the most urgent, which is why symptoms are evaluated quickly rather than 'watched'.
• Non-cardiac causes are common too: acid reflux, muscle or rib strain, anxiety, and lung conditions can all produce real chest discomfort.
• Symptoms can look different in women, older adults, and people with diabetes — fatigue, nausea, or breathlessness may be more prominent than classic pain.

1. 1

   If any emergency red flag applies, call 911 immediately. Emergency responders can begin evaluation on the way.

2. 2

   If symptoms have passed, write down what you felt, how long it lasted, what you were doing, and what made it better or worse.

3. 3

   Call your primary care clinician for any new or repeating chest discomfort, even if it seems mild.

4. 4

   Bring a current list of medications, supplements, and known conditions to any visit.

5. 5

   Ask about your cardiovascular risk factors: blood pressure, cholesterol, blood sugar, smoking, and family history.

• “Based on my history, how likely is a heart-related cause for this?”
• “Which tests do you recommend now, and what would each one rule in or out?”
• “What specific symptoms should make me call 911 rather than wait?”
• “Do any of my current medications contribute to this discomfort?”
• “What are my cardiovascular risk numbers, and what should I be aiming for?”
• “When should I follow up if the symptoms continue or change?”

• Heart Attack Symptoms, Risk, and RecoveryCenters for Disease Control and Prevention
• Angina (Chest Pain)National Heart, Lung, and Blood Institute (NIH)
• Warning Signs of a Heart AttackAmerican Heart Association

• Shortness of breath
• Persistent fatigue
• High blood pressure