This article was co-authored by Ni-Cheng Liang, MD. Dr. Ni-Cheng Liang is a board certified Pulmonologist and the Director of Pulmonary Integrative Medicine at Coastal Pulmonary Associates affiliated with the Scripps Health Network in San Diego, California. She also serves as a Voluntary Assistant Professor of Medicine at the University of California San Diego School of Medicine while volunteering for the UCSD Medical Student-Run Free Clinic for uninsured patients. With over 15 years of experience, Dr. Liang specializes in pulmonary and respiratory medical concerns, mindfulness teaching, physician wellness, and integrative medicine. Dr. Liang received her Doctor of Medicine (MD) from the University of Maryland School of Medicine. Dr. Liang was voted as a San Diego Top Doctor in 2017 and 2019. She was also awarded the 2019 American Lung Association San Diego Lung Health Provider of the Year.
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Chest pain does not necessarily suggest a heart issue. Of the 5.8 million Americans who visit emergency rooms for chest pain every year, 85% get diagnoses unrelated to the heart. However, because so many problems can cause chest pain — from heart attack to acid reflux — you should always see a doctor as soon as possible to determine the cause. In the meantime, there are ways to ease the pain on your own while waiting to receive professional attention.[1]
Steps
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Recognize the symptoms of a heart attack. A heart attack occurs when the arteries that feed blood to your heart get clogged, blocking off blood flow. This damages the heart and causes the chest pain associated with a heart attack. The chest pain experienced during a heart attack can be described as dull, achy, squeezing, tight, or like a heavy pressure. It focuses around the center of the chest. To make sure you're having a heart attack, look for its other symptoms:[2]
- Shortness of breath
- Nausea or vomiting
- Light-headedness or dizziness
- Cold sweats
- Pain in the left arm, jaw, and neck.
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Seek immediate emergency attention. Either call emergency services or ask someone to take you to the emergency room. The faster the doctors can clear the blockage, the less damage it can do to the heart.[3]Advertisement
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Take aspirin if you're not allergic. Most blockages that lead to heart attack are the result of clot-causing platelets (blood cells) that are attracted to a plaque buildup from cholesterol. Even a small amount of aspirin will suppress the presence of platelets in your blood, thinning both blood and clots.[4]
- Studies show that chewing the aspirin tablet is more effective at treating the clot, easing the chest pain, and preventing damage than swallowing it.
- Slowly chew on a 325 mg tablet of aspirin while waiting to receive emergency attention.
- Get the aspirin into your system as soon as possible.
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Get as comfortable as possible. You don't want to move around or do anything to get your blood pumping, as this could cause further damage to the heart. Sit down in a comfortable position and do your best to stay calm. Loosen or remove any restrictive clothing, and try to relax as best you can.[5]
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Learn the symptoms of pericarditis. Pericarditis occurs when the pericardium (a membrane around the heart) is swollen or irritated, usually from viral infection. The resulting chest pain usually feels like a sharp, stabbing pain in either the center or the left side of your chest. In some patients, though, the pain is more of a dull pressure that spreads to the jaw and/or left arm. This pain can worsen with breathing or movement. Some of the symptoms of pericarditis look a lot like those of a heart attack:[6]
- Shortness of breath
- Heart palpitations
- Low-grade fever
- Fatigue or nausea
- Cough
- Swollen legs or abdomen
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Seek immediate medical attention. Though pericarditis is often mild and resolves on its own, it's difficult to distinguish between its symptoms and those of a heart attack. It can also develop into more severe cases that can require surgery to relieve the symptoms. You need immediate supervision and diagnostic tests to find out what's actually causing the pain.
- Call emergency services or ask someone to take you to the nearest emergency room.
- Just like with heart attacks, early treatment is the best way to prevent the condition from worsening.
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Ease the pain by sitting up and leaning forward. The pericardium has two layers of tissue that rub together when inflamed, causing the chest pain. By sitting in this position, you can reduce the tissue friction and its resulting pain while waiting for medical attention.[7]
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Take aspirin or ibuprofen. Taking a non-steroidal anti-inflammatory drug like aspirin or ibuprofen will reduce the tissue inflammation. This, in turn, reduces the friction between the two layers of the pericardium and eases your chest pain.[8]
- Consult your doctor before taking these medications.
- With physician approval, take these medications three times a day with food. You should take a total of two to four grams of Aspirin per day or 1200 to 1800 mg of ibuprofen per day.
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Get plenty of rest. Pericarditis is usually the result of a viral infection. You can treat it like the common cold to speed up your recover and eliminate the pain quickly. Rest and sleep will help your immune system function more efficiently, speeding up the healing process.
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Recognize the severity of lung conditions. If your legs are swollen or you have been sitting for a long time as in an overseas plane ride, blood clots can form and spread to your lung arteries, causing blockage. Lung conditions cause chest pain that can worsen when you breathe, move, or cough.
- Get to an emergency room as quickly as possible.
- Lung conditions may require emergency surgery to alleviate symptoms.
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Look for the symptoms of pneumonia. Pneumonia is an infection that affects the air sacs in the lungs. They become inflamed, and can fill with fluid, which results in the phlegm and mucus you see when you cough. The chest pain you experience may be accompanied by:[9]
- Fever
- Coughing up mucus or phlegm
- Fatigue
- Nausea, and vomiting
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See a doctor if your pneumonia symptoms grow severe. In mild cases, you can simply rest at home and wait for your immune system to fight off the infection. But if the infection grows severe it can become life-threatening, especially in children and the elderly. See your doctor if:[10]
- You have trouble breathing
- The chest pain worsens significantly
- You have a fever of 102 F (39 C) or higher that won't go down
- Your coughing won't subside, especially if you're coughing up pus
- Be especially careful with children under two, adults over 65, and anyone else with a compromised immune system.
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Ask your doctor for medication. If a bacterial infection has caused the pneumonia, the doctor can prescribe antibiotics (azithromycin, clarithromycin, or erythromycin) to fight the infection and speed up recovery. However, even if antibiotic treatment is not an option for your infection, he can still give you medication to deal with the chest pain or reduce the coughing that worsens the pain.
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Watch for the symptoms of pulmonary embolism and pneumothorax. A pulmonary embolism occurs when a blockage develops in a lung (pulmonary) artery. Pneumothorax (collapsed lung) occurs when air leaks into the space between your lungs and your chest wall. Both conditions cause severe shortness of breath or a bluish discoloration of the fingers and mouth.[11]
- In delicate patients such as the elderly or long-term asthma sufferers, the intense coughing from pneumonia can sometimes cause a lung blockage or tear in the lung.
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Seek immediate medical attention for pulmonary embolism and pneumothorax. If you suspect a pulmonary embolism or pneumothorax, then seek immediate medical attention. In addition to chest pain, both conditions cause severe shortness of breath or a bluish discoloration of the fingers and mouth.[12]
- Both conditions require immediate medical attention. The blood leaking into the chest cavity or the air escaping into it can rapidly collect and compress your lungs. These conditions will not resolve on their own, but require medical assistance. Call emergency services or get to an emergency room as quickly as possible.
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Make sure you have acid reflux. Acid reflux occurs when stomach acid irritates the connection between the stomach and esophagus, causing it to relax. This then causes the acid to rise from the stomach into the esophagus, resulting in a burning pain in the chest. People with acid reflux may also experience nausea or a feeling like food is stuck in the chest or throat. It sometimes leaves an acidic taste in the mouth.[13]
- The condition is usually triggered or worsened by fatty or spicy meals, especially if you lay down after eating.
- Alcohol, chocolate, red wine, tomatoes, citrus fruits, peppermint, caffeinated products and coffee can cause acid build up and reflux.
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Sit up or stand. When you feel that familiar burning sensation, avoid lying down. Acid reflux happens in the esophagus, and lying down encourages stomach acid to flow through it. Sit up to help keep the acid from easily entering the esophagus.[14]
- You can also try doing some gentle movement, such as rocking in a chair or walking. This may help to improve your digestion.
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Take an antacid. Tums, Maalox, Pepto-Bismol, and Mylanta are all over the counter antacids that can relieve heartburn symptoms quickly. Take these drugs either after meals or after you begin feeling symptoms. You can also find antacids that can be taken before meals to prevent heartburn altogether. Read the instructions on the labels carefully, and take the drugs as directed.[15]
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Think about taking medication to reduce acid production. While antacids prevent reflux, Prilosec and Zantac work to stop acid production in the stomach.[16]
- Prilosec is an over the counter proton pump inhibitor that stops acid production in your stomach. Take 1 tablet at least an hour before your meals to slow down acid reflux. Make sure that you read the insert carefully to ensure you understand how this medication will affect your overall digestion.
- Zantac works achieves the same effect by blocking receptors for Histamine. Place a tablet in a glass of water and wait for it to dissolve. Drink the mixture 30 to 60 mins before your meal to reduce acid production.
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Make a simple, homemade treatment. A mixture of baking soda and water can be useful in easing acid reflux pain. Simply mix 1 or 2 tablespoons of baking soda into a glass of water and drink it when you feel chest pain from acid reflux. The bicarbonate found in baking soda will help neutralize the acid.
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Try herbal treatment. Make a cup of chamomile or ginger tea, or add ginger root to your meals. These two herbs may help with digestion, and can possible have a soothing effect on your stomach.[17]
- DGL-licorice (Glycyrrhiza glabra) extract can help coat the mucous lining of the esophagus and prevent the damage and pain of acid reflux.
- Take 250 to 500 mg capsules three times daily, chewed either one hour before or two hours after meals. If you take this for a prolonged period, visit your doctor to have him check your potassium levels. Licorice can reduce the potassium content in your body, which in turn can cause heart palpitations and arrhythmias.
- Buy deglycyrrhizinated capsules to prevent side effects such as swelling.
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Consider acupuncture treatment. Several very small studies suggest acupuncture can have a positive effect in the treatment of gastrointestinal disorders. In a 6 week study, acid reflux patients were given traditional Chinese acupuncture at 4 specific points on the body. The acupuncture group had results similar to the group treated with traditional medication. Tell the acupuncturist to focus on the following areas once a day for a week:[18]
- Zhongwan (CV 12)
- Bilateral Zusanli (ST36)
- Sanyinjiao (SP6)
- Neiguan (PC6)
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Ask a doctor for prescription strength medication if necessary. If you find that over the counter treatments and home remedies aren't doing the trick, you may need prescription strength help. The OTC medication Prilosec is also produced in prescription strength, and may be able to help ease your pain.[19]
- Be sure to follow the medication insert’s advisements on changes you may experience in digestion.
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Learn what a panic or anxiety attack is. These attacks are largely triggered by feelings of restlessness, nervousness, fear, or stress. To prevent attacks from recurring, patients should get behavioral therapy and possibly psychiatric medication. Highly emotional states can increase your breathing rate, straining the chest muscles to the point of pain. They can also make the esophagus or the coronary (heart) arteries spasm, which you would feel in your chest.[20] In addition to chest pain, you may experience:
- Increased breathing
- Increased heart rate
- Shaking
- Heart palpitations (feeling that your heart is jumping out of your chest)
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Breath deeply and slowly. Hyperventilation can cause spasms in the chest muscles, arteries and esophagus. Slow, deep breathing reduces the respiratory rate, decreasing your chance of painful spasms.
- Count to three in your head on each inhalation and each exhalation.
- Controlled your breathing instead of letting air rush in and out of your body. By controlling your breath, you can take control of your anxiety or panic.[21]
- If you have to, use a breath volume limiting device like a paper lunch bag held to your mouth and nose to limit the amount of air your body takes in. This can cut off the cycle of hyperventilation.
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Use relaxation techniques. A small study suggests massage therapy, thermotherapy, and relaxing room therapy are effective in treating generalized anxiety disorder.[22] After a 12-week course of these relaxation techniques, the subjects showed a reduction in the symptoms of anxiety and depression.
- Schedule a 35-minute massage that focuses on indirect myofascial release (trigger points). Also ask the massage therapist to focus on muscle restrictions in the shoulder, cervical, thoracic, and lumbar spine, the neck and back of head, and the bony area on top of the buttocks.
- Find a comfortable position on the massage table, using blankets or towels to make any adjustments you need.
- Play music that makes you relax, and take slow, deep breaths.[23]
- Ask the massage therapist to use Swedish massage techniques between muscle groups to transition between them.
- Ask the massage therapist to place warm towels or heating pads on your muscles. When he or she transitions between muscle groups, remove the heat to experience cold transitions between groups.
- Take slow deep breaths during the session.
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Schedule an appointment with a psychiatrist. If the panic attacks begin to interfere with your life, and relaxation techniques have not worked, you may need professional help. See a psychiatrist to talk about the possible causes of your anxiety. A steady routine of 1-on-1 therapy is the best way to ease your symptoms.[24]
- Therapists sometimes prescribe benzodiazepines or antidepressants to people who experience panic attacks. These medications treat the symptoms during an attack and prevent you from having future ones.
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Be able to distinguish costochondritis and musculoskeletal pain. The ribs are connected to the sternum through the cartilage in the "chondrosternal" joint. When that cartilage gets inflamed — usually from strenuous activity — you can feel chest pain from costochondritis. Exercise may also strain chest muscles, leading to musculoskeletal pain that feels like costochondritis. The pain can be sharp, aching, or feel like pressure on the chest. You usually will feel it only when you move or breathe. However, these two causes of chest pain are the only ones that can be reproduced by putting pressure on the area with your hand.[25]
- To tell the difference between musculoskeletal and cartilage joint pain, press on the ribs around the sternum (bone in center of your chest).
- If there's pain next to the sternum, chances are you have costochondritis.
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Take over the counter pain medication. Nonsteroidal anti-inflammatory drugs like aspirin, ibuprofen, and naproxen will ease the pain from cartilage and muscular chest pain. These drugs suppress the inflammation process — whether in the cartilage or the muscles — reducing the conditions that cause pain.[26]
- Take 2 pills or tablets with water and food. The food helps prevent irritation of the stomach.
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Get plenty of rest. The pain from these conditions is self-limiting, meaning that it will go away with time instead of lingering. However, you need to rest your strained muscles and your rib joints to give the damaged tissue a chance to heal. If you don't want to stop exercising completely, at least reduce the exercises that put stress on the chest area.
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Stretch beforehand if you exercise.[27] If you don't adequately stretch your muscles before strenuous activity, you will feel tightness and pain in them after you stop. This is the last thing you want when you're experiencing cartilage or muscle pain. Before beginning your exercise sessions, make sure to stretch the muscle groups in the chest:
- Lift your arms straight over your head, then stretch as far to the back and sides as you can. Really let your chest muscles expand and relax as you do this.
- While facing a corner, stretch your arms out fully and place one hand on each wall. Move your hands further apart from each other, letting your chest come closer to the wall in the process.
- With your feet planted on the ground, get a firm hold of the sides of an open door. Lunge your chest forward, holding your body up by your grip on the doorframe. You can also simply walk forward while holding onto the doorframe.
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Use a heating pad. Heat can be an effective therapy for ongoing muscle or joint issues, and can ease this type of chest pain. Place the heat pad in the microwave and heat as described in the directions. Place it over the painful areas intermittently so you don't burn yourself. The heat will loosen the tension in your muscles and promote healing. You can also massage the area after applying heat with the pads of your fingers to further loosen the muscles.[28]
- Taking a warm bath with a cup of Epsom's salts in the water can also ease the pain in your cartilage and muscles.
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Make an appointment with a healthcare professional if symptoms continue. If you're continuously straining your chest muscles, don't expect the pain to go away quickly. However, if the pain lingers even with plenty of rest, you should schedule an appointment with your doctor.
- Seek immediate attention if you were in an accident involving chest trauma. A broken rib can damage the lungs and heart if left untreated. Your doctor may perform an x-ray to note any broken bones.
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Tips
Tips from our Readers
- If the pain is caused by a cold or congestion, take some decongestant to loosen up the mucus build up in your lungs.
- Lying on your side can make the pain worse, since it puts pressure on your chest and lungs.
- Tell someone as soon as your pain starts, just in case it’s serious.
Warnings
- Because chest pain can have so many different causes — some harmless and some potentially fatal — you should always see a doctor as soon as possible when you experience it. If you don't know the cause of the pain, you need to be diagnosed.Thanks
- It's especially important to see a doctor is the pain grows unbearable, if you have trouble breathing, or if it lingers for days without relief.Thanks
- Take care to get immediate medical diagnosis especially if you have a family history or heart conditions.Thanks
- If you sustain a serious traumatic injury to your chest (eg. car accident), seek immediate medical attention for potential broken bones.Thanks
- Don't think the pain is not serious just because it's on the right side of the chest, as opposed to the left. Right side chest pain can be a sign of a serious condition as well.Thanks
- If you suspect a heart attack in yourself or anyone else, always dial 999 (UK) or 911 (USA) immediately. They would much rather be called out and discover it is not a heart attack than discover too late that it is.Thanks
References
- ↑ https://www.ucsf.edu/news/2016/06/403211/chest-pain-common-actual-severity-rare
- ↑ https://www.nhlbi.nih.gov/health-topics/heart-attack
- ↑ https://medlineplus.gov/ency/article/000063.htm
- ↑ http://www.health.harvard.edu/heart-health/aspirin-for-heart-attack-chew-or-swallow
- ↑ http://www.nlm.nih.gov/medlineplus/ency/article/000063.htm
- ↑ https://www.bhf.org.uk/informationsupport/conditions/pericarditis
- ↑ http://www.aafp.org/afp/2007/1115/p1509.html
- ↑ http://emedicine.medscape.com/article/156951-medication
- ↑ https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/symptoms-and-diagnosis
- ↑ https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/symptoms-and-diagnosis
- ↑ https://www.hopkinsmedicine.org/health/conditions-and-diseases/pulmonary-embolism
- ↑ https://www.hopkinsmedicine.org/health/conditions-and-diseases/pulmonary-embolism
- ↑ McCONAGHY J, Oza R. Outpatient Diagnosis of Acute Chest Pain in Adults. Am Fam Physician. 2013 Feb 1;87(3):177-182.
- ↑ https://gi.org/topics/acid-reflux/
- ↑ https://www.southerncross.co.nz/group/medical-library/heartburn-acid-reflux-causes-treatment
- ↑ https://gi.org/topics/acid-reflux/
- ↑ https://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/module_gerd_patient.pdf
- ↑ Zhang CX, Qin YM, Guo BR. Clinical study on the treatment of gastroesophageal reflux by acupuncture. Chinese Journal of Integrative Medicine. 2010 Aug;16(4):298-303
- ↑ https://www.aaaai.org/Conditions-Treatments/related-conditions/gastroesophageal-reflux-disease
- ↑ Huffman J, Pollack M, Stern T. Panic Disorder and Chest Pain: Mechanisms, Morbidity, and Management. Primary Care companion Journal Clinical Psychiatry. 2002; 4(2): 54–62.
- ↑ http://www.helpguide.org/articles/anxiety/panic-attacks-and-panic-disorders.htm
- ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922919/
- ↑ Sherman K. et al. Effectiveness of Therapeutic Massage for Generalized Anxiety Disorder: A Randomized Controlled Trial. Depression & Anxiety Journal. 2010. May; 27(5): 441-450.
- ↑ https://www.anxietycanada.com/learn-about-anxiety/anxiety-in-adults/
- ↑ http://www.aafp.org/afp/2009/0915/p617.html
- ↑ https://my.clevelandclinic.org/health/diseases/15851-gerd-non-cardiac-chest-pain
- ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273886/
- ↑ https://my.clevelandclinic.org/health/diseases/15851-gerd-non-cardiac-chest-pain
About This Article
If you have sudden chest pain that’s accompanied by shortness of breath, dizziness, nausea, cold sweats, or pain in your left arm, you might be having a heart attack and you should call emergency medical services. While you wait for help, chew an aspirin, which can help de-clog your arteries. Sudden chest pain can also be a sign of Pericarditis or a lung condition, especially if you also have shortness of breath, heart palpitations, a low-grade fever, a cough, or swollen legs or abdomen. If you have any of these symptoms, call for help immediately. Sudden chest pain can also be caused by acid reflux or a panic attack. Take an antacid or drink some ginger tea to help relieve your pain. If you’re having a panic attack, try to breathe slowly and deeply to help yourself calm down. To learn how to ease chest pain caused by musculoskeletal conditions, read more from our Medical co-author.
Reader Success Stories
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"Leaning forward to ease (possible) pericarditis pain. I likely don't have percarditis, but I was searching for any method to ease the pain around/under my heart, which is continuing since yesterday. Leaning forward has helped."..." more