Are You Sick?

Chest Pain

Is this your symptom?

Pain or discomfort in the chest (front or back)
The chest includes from the top to the bottom of the rib cage
Care guide does not cover pain due to a chest injury

Causes of Chest Pain

There are many problems that can cause chest pain. The pain can range from a sharp stab to a dull ache. It can feel crushing, burning or tearing or can be like an ache or heavy feeling in the chest. Sometimes, the pain goes up the neck, and/or into the jaw. It can also go into the back or down one or both arms. The most serious causes can be life-threatening. They can often be treated successfully when diagnosed quickly. It's important to seek help right away.

Less Serious Causes

Muscle Overuse. Chest pain can follow hard work-outs or activities (such as throwing a baseball). Lifting (such as weights) or upper body work (such as digging) can also cause it. This type of muscle soreness often increases with movement of the shoulders.
Muscle Cramps. Most brief chest pain, lasting seconds to minutes, is from muscle cramps (often the ribs). These fleeting pains can also be caused by a pinched nerve. These chest wall pains are harmless. Brief muscle cramps are also the most common cause of recurrent chest pains.
Coughing. Chest pain often happens with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm.
Asthma. People with active asthma often have chest tightness. They may refer to this as chest pain. They also get chest pain when they have lots of coughing.
Heartburn is due to reflux of stomach contents. It usually causes a burning pain under the lower sternum (breastbone).
Caffeine. A rapid and pounding heart beat may feel like chest pain. Too much caffeine (in energy drinks, colas and coffee) is a common cause. Drugs taken for ADHD also can cause a fast heartbeat. So can illegal drugs, such as cocaine.

More Serious Causes

Chest Wall Injury. Blunt trauma, such as falling onto something or a blow to the chest (thrown object or impact with another person during sports) usually just causes a bruised rib. Sometimes, it causes a broken rib (fracture). Pain from broken ribs may last for several weeks before starting to ease.
Heart Disease (serious). Heart disease is a common cause of chest pain in adults. Chest pain that only occurs with exercise could have a cardiac (heart) cause. It is important to seek care right away if this happens. Life-saving treatment is important at this stage, before the condition gets worse and becomes life-threatening. Heart pain can also occur if the heart beat feels too fast, too slow or with an uneven beat. Sometimes a change in heart rate or rhythm only lasts for a few minutes and does not cause any other symptoms. But it can occur with dizziness, fainting, chest pain or breathing trouble. See your doctor if any of these occur.
Pleurisy (serious) is an infection near the surface of the lung that causes pain as you take a breath. It can happen with pneumonia. If the infection involves the lung's surface, that area of the chest will hurt.
Pulmonary Embolus (serious) occurs when a clot from somewhere in the body (often the legs) travels through the blood stream and gets trapped in the lungs. A large clot can be life-threatening. Symptoms include breathlessness, chest pain and coughing up blood.

Pain Scale

Mild: you feel some pain, but it does not keep you from any normal activities. Work, activities and sleep are not changed.
Moderate: the pain keeps you from doing some normal activities. It may wake you up from sleep.
Severe: the pain is very bad. It keeps you from doing all normal activities.

When to Call for Chest Pain

When to Call for Chest Pain
Call 911 Now Severe constant chest pain (you are not able to move or do anything) Severe trouble breathing (struggling for each breath, can barely speak) Passed out (fainted) or feel like you might pass out Confused Bluish lips or face or you appear very pale Heavy sweating A tearing feeling in the chest, abdomen or back Pain that goes into the neck, jaw or arm Not moving or too weak to stand You think you have a life-threatening emergency Call Doctor or Seek Care Now You have known heart disease The chest pain you get from your known heart disease feels different. Examples: it comes on more easily, is worse, lasts longer than usual or does not go away with usual treatment. New chest pain that happens when you walk or exercise; it goes away when you rest Trouble breathing, but not severe Taking a deep breath makes the pain worse Fever or chills; feeling hot or shivery Pain happened after a direct blow or injury to the chest You feel weak or very sick You think you need to be seen, and the problem is urgent	Contact Doctor Within 24 Hours Cause of chest pain is not clear. Not due to coughing, sore muscles, heartburn or other clear cause. Rash or blisters in the chest area You think you need to be seen, but the problem is not urgent Contact Doctor During Office Hours Chest pains only occur with hard exercise (such as running) Sore chest muscles last more than 7 days Heartburn lasts more than 2 days on treatment Mild chest pains happen often You have other questions or concerns	Self Care at Home Normal chest pain from coughing or sore muscles Normal chest pain from heartburn

Call 911 Now

Severe constant chest pain (you are not able to move or do anything)
Severe trouble breathing (struggling for each breath, can barely speak)
Passed out (fainted) or feel like you might pass out
Confused
Bluish lips or face or you appear very pale
Heavy sweating
A tearing feeling in the chest, abdomen or back
Pain that goes into the neck, jaw or arm
Not moving or too weak to stand
You think you have a life-threatening emergency

Call Doctor or Seek Care Now

You have known heart disease
The chest pain you get from your known heart disease feels different. Examples: it comes on more easily, is worse, lasts longer than usual or does not go away with usual treatment.
New chest pain that happens when you walk or exercise; it goes away when you rest
Trouble breathing, but not severe
Taking a deep breath makes the pain worse
Fever or chills; feeling hot or shivery
Pain happened after a direct blow or injury to the chest
You feel weak or very sick
You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Cause of chest pain is not clear. Not due to coughing, sore muscles, heartburn or other clear cause.
Rash or blisters in the chest area
You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Chest pains only occur with hard exercise (such as running)
Sore chest muscles last more than 7 days
Heartburn lasts more than 2 days on treatment
Mild chest pains happen often
You have other questions or concerns

Self Care at Home

Normal chest pain from coughing or sore muscles
Normal chest pain from heartburn

Care Advice

Mild Chest Pain Treatment (from sore muscles)

What You Should Know About Mild Chest Pain:

Chest pains lasting for a few seconds or minutes are usually harmless.
Chest pains that last longer can be from hard work or sports. The shoulders are usually involved. Sore muscles can start soon after the event.
But if you have chest pain that does not go away quickly or you get pain often, you should get it checked out by your doctor.
Here is some care advice that should help.

Pain Medicine:

To help with the pain, take an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Use as needed, but do not take more than the maximum recommended dosage, as stated on the package.
Continue this until you have been pain-free for 24 hours.

Cold Pack for Pain:

For the first 2 days, use a cold pack to help with the pain.
You can also use ice wrapped in a wet cloth.
Put it on the sore area for 20 minutes, then as needed.
Caution: avoid frostbite by wrapping the cold pack in a towel. Do not put ice directly on the skin.

Use Heat After 48 Hours:

If pain lasts more than 2 days, put heat on the sore area.
Use a heat pack, heating pad or warm wet washcloth.
Do this for 10 minutes, then as needed.
Reason: increases blood flow and improves healing.
Caution: avoid burns.
A hot shower may also help.

Stretching the Muscles:

Gentle stretching of the shoulders and chest wall may help.
Do sets of 10 stretches, twice daily.
This may prevent muscle cramps from coming back.
Stretching can be continued even during the chest pain. Do not do any exercises that increase the pain.

What to Expect:

For sore muscles, the pain most often peaks on day 2.
It can last up to 6 or 7 days.

Call Your Doctor If:

Pain becomes severe
Pain lasts over 7 days on treatment
You think you need to be seen
Your symptoms get worse

Heartburn (Acid Reflux) Pain Treatment

What You Should Know About Heartburn:

Heartburn is common.
It's due to stomach acid going up into the esophagus. The esophagus is the tube from the mouth to the stomach.
Heartburn causes a burning pain behind the lower part of the breastbone. It also causes a sour (acid) taste in the mouth and belching.
Here is some care advice that should help.

Antacids:

Heartburn is often easily treated. Take a calcium-based antacid by mouth (such as Mylanta, Tums or the store brand). They come as a liquid or tablet. No prescription is needed.
Follow the dosage on the package.
If you don't have an antacid, use 2 to 3 ounces (60 - 90 mL) of milk.
For heartburn that keeps coming back, take an antacid 1 hour before meals. Also, take a dose at bedtime. Do this for a few days.

Heartburn Prevention:

Do not eat too much at meals. This overfills the stomach.
Do not eat foods that make heartburn worse. Examples are chocolate, fatty foods, spicy foods, carbonated soda, alcohol and caffeine.
Do not bend over for 3 hours after meals.
Do not wear tight clothing or belts around the waist.