Chest Pain – Diagnosis and Treatment

ByJanis Updated

Diagnosis

First Steps in Evaluation

When someone has chest pain, doctors quickly check for life-threatening problems, especially heart attacks and dangerous lung issues like pulmonary embolism or a collapsed lung. Medical staff use a few fast tests right away:

Test Name What It Checks For How It Works
Electrocardiogram (ECG) Heart attack or other heart issues Wires attached to sticky pads record the heart’s electrical activity.
Blood tests Signs of heart damage (like heart attack) Looks for proteins and chemicals in the blood linked to damaged heart cells.
Chest X-ray Problems with lungs, heart size, or rib pain Takes a picture of the inside of the chest using X-rays.
CT scan of the Chest Blood clots, aortic dissection, more lung details Makes detailed images with X-rays to reveal blood clots or torn arteries.

Doctors use these tests to quickly find or rule out critical conditions such as aortic dissection, pulmonary embolism, or pericarditis.

Additional Checks If Needed

If the first tests do not give a clear answer, doctors may order more tests. The next steps depend on your symptoms and initial results.

Later tests may include:

  • Heart ultrasound (echocardiogram): Doctors use sound waves to make live images of the heart. This shows how well the heart works and checks for problems like pericarditis.

  • CT Angiogram: Doctors use a CT scan with special dye to look closely at the heart’s arteries and find narrow or blocked vessels.

  • Exercise Stress Test: You walk on a treadmill or ride a stationary bike while doctors watch your heartbeat. This test shows how your heart handles activity.

  • Cardiac Catheterization: A doctor guides a thin tube into a blood vessel and up to the heart. Dye goes into the blood to help find blockages in arteries on X-ray pictures.

These tests help doctors diagnose conditions like costochondritis or refine details about possible lung and heart problems.

Doctors use test results, a physical exam, and questions about your symptoms to find the cause of chest pain. They choose the best treatment based on your overall health, risk factors, and test findings.

Treatment

Medicines Used for Chest Pain Relief

Doctors pick treatments based on the cause of chest pain. Here are some common medicines:

Medicine Type Main Use How It Works
Nitrate Angina Relaxes heart blood vessels
Aspirin Heart attacks, blockages Reduces clotting
Thrombolytics Heart attack Breaks up clots
Blood thinners Clots in arteries Prevents new clots
Acid controllers Heartburn Lowers stomach acid
Anti-anxiety drugs Panic attacks Calms nervous system

  • Nitrate: Doctors give nitroglycerin to people with narrowed heart arteries. It relaxes and opens blood vessels, letting more blood reach the heart muscle and easing angina.

  • Medicines to Lower Blood Pressure: Some blood pressure drugs help widen arteries. This lowers the heart’s workload and can reduce pain.

  • Aspirin: When doctors suspect heart problems, they often give aspirin. It helps prevent blood clots, lowering the chance of a heart attack getting worse.

  • Drugs That Break Up Clots (Thrombolytics): For heart attacks caused by blocked arteries, doctors may use clot-busting medicines. These dissolve the blockage and restore blood flow.

  • Blood Thinners: Blood thinners help stop new clots from forming in the arteries to the heart or lungs.

  • Stomach Acid Control Medicines: For chest pain from heartburn, doctors may suggest acid-reducing drugs. These lower stomach acid.

  • Medicines for Anxiety: If chest pain is linked to panic attacks, doctors may recommend anti-anxiety medicines or counseling.

Medical Procedures and Surgeries

If medicines do not control chest pain, doctors may suggest procedures or surgery.

  • Angioplasty with Stent: Doctors fix blockages in heart arteries by guiding a thin tube into a blood vessel up to the heart. A balloon opens the artery, and a mesh tube (stent) keeps it open.

  • Heart Bypass Surgery: Surgeons use a healthy blood vessel from another part of your body to make a new path around a blocked heart artery. This increases blood flow to the heart and lowers the risk of angina or heart attack.

  • Emergency Repairs for Major Artery Tears: If the aorta tears, doctors may need to do urgent surgery to repair it and prevent life-threatening problems.

  • Chest Tube to Reinflate a Lung
    If a lung collapses, doctors place a tube in the chest to help the lung expand again.

Doctors decide on these treatments based on the cause and seriousness of the chest pain. The main goal is to restore blood flow, protect the heart, and ease symptoms.

Getting Ready for Your Visit

Steps You Can Take

If you have chest pain that is severe, new, or lasts more than a few minutes, act fast. Call 911 or emergency medical help right away.

Do not delay because you feel embarrassed or unsure. Fast care can make a big difference.

If you have time, gather key information before going to the hospital. This helps the medical team treat you more quickly.

Things to Prepare:

  • A List of Symptoms: Write down what you feel, when the pain started, how strong it is, and if it spreads. Note what makes it better or worse.
  • Medical History: Mention if you had chest pain before and what caused it. Include any family history of heart disease, diabetes, or other illnesses.
  • Current Medicines: Bring a list or photo of all medicines and supplements you take. Include prescription drugs, vitamins, and over-the-counter products.
  • Information About Allergies: Note any drug or food allergies so the staff can choose safe treatments.

Common Symptoms to Share

Symptom Type Details to Describe
Chest pain When it started, location, strength, duration
Shortness of breath When it happens, what makes it worse
Dizziness/lightheadedness Is it constant or does it come and go?
Nausea/vomiting If it happens with the pain
Sweating If it’s more than usual during pain
Palpitations Fast or irregular heartbeat
Anxiety or panic Feelings of panic attacks, fear, or restlessness

People sometimes confuse chest pain from a heart problem with a panic attack. Both can feel similar, so it is hard to tell the difference without a doctor.

Tell your doctor if you feel anxiety or panic, especially with chest pain, trouble breathing, or a racing heart.

Questions You Might Want to Ask

Write down questions for your doctor. Some examples:

  • What could be causing my pain?
  • Are there other possible reasons for these symptoms?
  • What tests will I need, and why?
  • Will I need to stay in the hospital?
  • What treatments will start right away?
  • Are there any risks to these treatments?
  • What comes next for care and follow-up?
  • How do my other conditions or medicines affect my treatment?
  • Will I need to change my daily routine after leaving the hospital?
  • Should I see a certain type of doctor after this visit?

Having notes, symptom details, and questions helps the medical team give you better care. Family members can help collect this information and support you at the hospital.

What the Medical Team Will Likely Ask

During your visit, a health professional will ask many questions to find the cause of your chest pain. They do this to decide quickly if your pain is from the heart or another cause.

Common Questions Include:

  1. Details of the chest pain:
    • When did it start?
    • How long does it last?
    • Is it getting worse or staying the same?
  2. Pain characteristics:
    • How does the pain feel (sharp, dull, squeezing, burning, pressure)?
    • On a scale from 1 to 10, how bad is it?
    • Does the pain spread to the arm, back, jaw, or neck?
  3. Other symptoms experienced:
    • Are you having trouble breathing?
    • Any dizziness, lightheadedness, or weakness?
    • Nausea or vomiting?
    • More sweating than usual?
  4. Personal and family history:
    • Have you had similar pain before?
    • Any history of high blood pressure or heart disease?
    • Do family members have heart conditions, diabetes, or similar symptoms?
  5. Lifestyle details:
    • Do you use tobacco, alcohol, caffeine, or drugs?
    • If yes, how much and how often?
  6. Other health issues:
    • What other medical conditions do you have?
    • Are you taking medicines for high blood pressure or other illnesses?

Quick Reference Checklist

What the Doctor May Ask What to Tell Them
When did pain start? Exact date and time, if possible
What makes pain better or worse? Any patterns you noticed
How would you describe the pain? Use simple words like sharp, dull
Where does the pain go? Any areas besides the chest
Other symptoms? List all symptoms, even if minor
Your drug and lifestyle habits Be honest about tobacco, alcohol, caffeine, or drug use
Family medical history Heart, lung, or similar problems in family

If you have trouble remembering details, bring someone who knows your health or can help answer questions.

Doctors use your answers and test results to find out if you are having a heart attack, angina, panic attack, or another cause of chest pain. Honest and clear answers help ensure the safest and fastest care.

Helpful Tips

  • Keep a small card with your medicine list and health info in your wallet or phone.
  • Update the card regularly as medicines or health details change.

During stressful times, simple breathing exercises can help if symptoms are linked to anxiety or a panic attack. Only try this after a doctor rules out a heart problem.


Related Questions

Responses are AI-generated

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.