What immediate actions are appropriate when a patient complains of chest pain?

Key facts

• Chest pain is any sort of pain felt from your jaw down to the bottom of your ribs.
• Chest pain can be a symptom of a heart attack and should be considered heart-related until proven otherwise.
• All chest pain should be checked out by a doctor as soon as possible.
• The symptoms of a heart attack can be different in men and women.

On this page

• What is chest pain?
• When should I call an ambulance?
• While waiting for the ambulance
• What are the warning signs of a heart attack?
• What are the causes of chest pain?
• Resources and support
• Related information on Australian websites

What is chest pain?

Chest pain is any sort of pain felt in your upper body, from your jaw down to the bottom of your ribs.

How do I know if my chest pain is serious?

Because chest pain can be a symptom of a heart attack or another cardiac condition, it's safest to consider the pain as heart-related, until proven otherwise.

When should I call triple zero (000) and ask for an ambulance?

If you have any of the symptoms below, call triple zero (000) immediately and ask for an ambulance. If calling triple zero (000) does not work on your mobile phone, try calling 112.

• your chest pain is severe, or worsening, or has lasted longer than 10 minutes
• your chest pain feels heavy, crushing or tight
• you have other symptoms, such as breathlessness, nausea, dizziness or a cold sweat
• you also feel the pain in your jaw or down your left arm

While waiting for the ambulance

Stop any activity and rest while waiting for an ambulance. Don’t try to drive yourself to hospital. Loosen any tight clothing, such as collar buttons or ties. Avoid breathing in cigarette smoke. Don’t have anything to eat or drink.

If you have been prescribed angina medicine, sit or lie down and take a dose of this under your tongue. If this doesn’t relieve your symptoms in 5 minutes, try taking 2 more doses at 5-minute intervals.

Chew 300mg aspirin straight away, unless you're allergic or your doctor has told you not to. Do not give aspirin to anyone under 12 years.

What are the warning signs of a heart attack?

There are several different warning signs of a heart attack, and they are not always sudden or severe. Whether or not your chest pain symptoms include mild to severe pain, they should be considered heart-related until proven otherwise.

People having a heart attack may have just one of these symptoms, or a combination of several. They can come on suddenly or develop over a few minutes and get progressively worse. Symptoms usually last for at least 10 minutes.

Warning signs could include:

• discomfort or pain in the centre of your chest — a heaviness, tightness or pressure, like something heavy sitting on your chest, or a belt tightening around your chest, or a bad case of indigestion
• discomfort in your arms, shoulder, neck, jaw or back
• other problems such as:
• a choking feeling in your throat
• your arms feeling heavy or useless
• feeling short of breath
• feeling nauseous
• having a cold sweat
• feeling dizzy or light-headed

Women and men can experience the signs and symptoms of a heart attack differently.

Although chest pain is thought to be the most common symptom of heart attack — and it is common in men — only about half of all women who have a heart attack actually report chest pain.

Heart attacks are more common in older people than in younger people, but they can occur in people of any age.

The pain you have may not sound like that described above, but it’s still important to see a doctor. Remember, all chest pain should be checked out by a doctor as soon as possible.

CHECK YOUR SYMPTOMS — Use our chest and back pain Symptom Checker and find out if you need to seek medical help.

What are the causes of chest pain?

Chest pain can be a symptom of many different conditions, some of which are more serious than others. It’s best to seek medical attention for any chest pain in case it is heart-related.

Common non-cardiac causes of chest pain include:

• indigestion or reflux (heartburn) — when stomach acid rises up the food pipe, and causes a burning pain in the chest –
• muscle strains
• inflammation where the ribs join the breast bone (known as costochondritis)
• chest infections such as bronchitis and pneumonia
• pleurisy (inflammation of the tissue lining the lungs)
• anxiety or panic attack — these may also cause dizziness, heart palpitations, sweating and breathlessness and can last for up to 20 minutes.

Common cardiac causes of chest pain include:

• angina — pain caused by poor blood flow to the heart muscle, which usually occurs when the heart needs to work harder than usual. This might be due to exercise, anxiety or emotion, cold weather, or following a large meal. The pain is usually short lived and eases with rest.
• heart attack — when the blood flow to a part of the heart muscle is blocked. Chest pain caused by a heart attack usually does not go away with rest, and urgent medical attention is necessary.

Less common causes of chest pain include:

• shingles (herpes zoster) — an infection that typically causes pain before a skin rash appears
• mastitis — usually caused by a breast infection related to breastfeeding
• inflammation of the gallbladder
• a pulmonary embolism — a blockage in the blood vessel that carries blood from the heart to the lungs. You may have sharp, stabbing chest pain that is worse when you breathe in.
• pericarditis (inflammation of the sac surrounding the heart)

Resources and support

Visit the Heart Foundation website for more information about heart attack symptoms.

Aboriginal and Torres Strait Islanders

This information has been developed for indigenous communities:

• Heart Foundation: Information and resources for heart health-related topics

Other languages

Do you prefer other languages than English? This website offers translated information:

• Heart Foundation: Fact sheets and resources covering a range of heart health-related topics (in more than 10 languages)

Tools

You might find this program helpful:

• Heart Foundation: My heart, my life

Call healthdirect

Call 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week (known as NURSE-ON-CALL in Victoria).

What immediate actions are appropriate for chest pain nurse?

What is the first step in caring for a patient who has chest pain?

What is chest pain protocol?