Types of Heart Attack Symptoms: Chest Pain

By Spader, Catherine, RN

Chest pain is often a frightening symptom that you probably associate with a heart attack. Although there are many less serious causes of chest pain, never hesitate to call 911 if you have sudden or severe chest pain or if you think you are having a heart attack.

Why Does a Heart Attack Affect My Chest?

Most often people have a heart attack when a blood clot blocks blood flow into the heart muscle. This commonly causes pain in the chest. Chest pain from a heart attack can also expand from your chest into your neck, jaw, shoulders, arms and back. Sometimes pain in these areas can occur by themselves without chest pain. This happens more often in women than in men.

Heart attack chest pains feel different from person to person. Chest pain may be described as a vague discomfort or:

  • Dull, achy pain

  • Cramping

  • Feeling like something heavy is laying on your chest

  • Pressure or fullness

  • Squeezing

  • Tightness

What Is the Difference Between a Heart Attack and Angina?

Most heart attacks occur after years of fatty plaque building up in the coronary arteries. Plaque buildup is called atherosclerosis. The coronary arteries supply the heart muscle with oxygen-rich blood. Atherosclerosis narrows the coronary arteries (coronary heart disease, CHD) and increases the risk that a blood clot will form in a coronary artery. This will block blood flow to the heart muscle causing a heart attack (death of the heart muscle, or myocardial infarction).

Many people who have a heart attack may first have a type of chest pain called angina. It occurs when atherosclerosis reduces the flow of oxygen-rich blood to the heart muscle. Angina can develop over years or start suddenly.

Angina can feel similar to the chest pain of a heart attack. It often occurs when your heart has to work hard during exercise or exertion, such as climbing stairs or shoveling snow. It generally goes away with rest or with medication prescribed by your doctor. If angina occurs at rest or lasts longer than usual, it may be a sign of a heart attack.

What Else Could Cause My Chest Pain?

Many common conditions are known to cause chest pain and feel like a heart attack:

  • Anxiety or panic attack, which often occurs with fast breathing and pounding in the chest

  • Aortic dissection, a condition in which the largest artery in your chest or abdomen tears and can rupture. It often causes a searing or tearing pain in the chest.

  • Costochondritis, an inflammation of the cartilage that joins the ribs to the breastbone. It generally causes a sharp chest pain, especially when taking a deep breath. This type of pain is often confused with pain coming from your heart (cardiac origin).

  • Gallstones, hard deposits in the gallbladder that can cause chest pain. This type of chest pain often gets worse after eating fatty foods.

  • Heartburn, acid reflux, or gastroesophageal reflux disease (GERD), a backup of stomach contents into the esophagus that often causes a burning sensation in the chest

  • Lung problems, such as pneumonia and pleurisy (an inflammation of the lining around the lung). Both conditions often cause sharp chest pain that is more severe when you cough or take a deep breath. Other lung conditions include pulmonary embolism (a blood clot in the lung) and pneumothorax (collapse of the lung).

  • Muscle strain of the chest muscles. This type of chest pain tends to get worse with movement.

  • Pericarditis, swelling in the sac that holds the heart. This type of chest pain generally causes pain in the middle of your chest.

  • Shingles, an infectious rash caused by the chickenpox virus. It causes severe, sharp, tingling pain on one side of your rib cage.

  • Stomach ulcer and gastritis (inflammation of the stomach), which often causes a burning chest pain when your stomach is empty and gets better when you eat

When Should I Call My Doctor or 911?

Every moment that goes by without treating a heart attack destroys more and more of your heart muscle. You may hesitate to call an ambulance because you are not sure that your chest pain is serious. Medical professionals would rather you call 911 for what turns out to be a minor problem than delay treatment of a possible heart attack.

By calling 911, your treatment will begin as soon as emergency medics arrive. They will also notify the ER at the hospital so the staff can continue care immediately on your arrival. As a precaution, all emergency personnel will treat you as if you are having a heart attack until all your tests are complete.

Do not hesitate to call 911 if you have sudden or severe chest pain that occurs with or without any of the following symptoms:

  • Anxiety, uneasiness , or sense of dread or doom

  • Feeling like you might throw up

  • Paleness or looking “white as a sheet”

  • Breaking out in a cold sweat

  • Discomfort or pain that spreads to your shoulders, arms, neck or jaw

  • Feeling like you can’t take breath or take a deep breath

  • Blacking out or feeling as if you might pass out

  • Weakness or fatigue

Medical Reviewer: McDonough, Brian, MD; Copyright: © Copyright 2012 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

Your Guide to Heart Attack


Take a Personalized Health Test