Chest Pain: When It's Your Heart and When It's Not

Medically reviewed by Dr Nabila Laskar, Consultant Cardiologist (GMC 7040901). Chest pain is one of the most common reasons people seek medical attention, and one of the hardest symptoms to self-diagnose. It can originate from the heart, lungs, digestive system, muscles, or anxiety — and telling these apart matters.

When Chest Pain Needs Emergency Care

Call 999 or go to A&E immediately for chest pain that is crushing, radiates to the arm/jaw/back, comes with breathlessness, sweating, nausea, or lasts more than a few minutes — these are classic signs of a possible heart attack and should never be assessed privately or wait for an appointment.

What Cardiac Chest Pain Typically Feels Like

Angina (chest pain from reduced blood flow to the heart muscle) is often described as a tightness, heaviness or pressure, typically triggered by exertion and easing with rest. It can be a warning sign of underlying coronary artery disease and should always be investigated.

Common Non-Cardiac Causes

Chest pain frequently comes from musculoskeletal strain, acid reflux, anxiety and panic attacks, or costochondritis (inflammation of the cartilage connecting ribs to the breastbone). These causes are common but should still be properly assessed to rule out a cardiac origin, particularly in those with risk factors.

How We Investigate Non-Emergency Chest Pain

Assessment typically includes a detailed history, examination, resting ECG, and where appropriate an echocardiogram or exercise/stress testing. Blood tests assessing cholesterol and other cardiovascular risk markers are often included to build a complete picture.

Frequently Asked Questions

Should I go to A&E or book a private appointment for chest pain?

Sudden, severe, or crushing chest pain — especially with breathlessness, sweating or radiating pain — requires emergency care immediately. Milder, recurrent, or exertion-related chest pain can be appropriately assessed via private cardiology review.

Can anxiety cause chest pain that feels like a heart problem?

Yes, anxiety and panic attacks commonly cause chest tightness that closely mimics cardiac pain. A proper cardiac work-up is the only reliable way to distinguish between the two.

What tests are used to investigate chest pain?

Typically an ECG, echocardiogram, and blood tests as a starting point, with further imaging such as CT coronary angiography added if initial results suggest underlying coronary disease.

Is chest pain always related to the heart?

No. The chest contains many structures — lungs, digestive organs, muscles, and ribs — any of which can cause pain. Proper assessment is needed to identify the actual source.

Book a consultation · +44 208 016 3678