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Chest pain



Chest pain can be frightening to some people, because it can be the signal of a heart attack. Although chest pain has many other causes, cardiac disease is very common and as it can be life-threatening you should never ignore chest pain or dismiss it as insignificant without a medical diagnosis.



How do I know if I’m having a heart attack?


Call 111 immediately if you have any of the following symptoms:


  • squeezing, tightening or crushing pressure in your chest
  • sudden severe pain that worsens over 15-20 minutes
  • pain that radiates to your left arm, your jaw or between your shoulder blades
  • nausea, dizziness, weakness or sweating along with pain
  • shortness of breath
  • a racing or erratic heartbeat
  • angina pain that suddenly becomes worse or continues when you are at rest
  • an overwhelming feeling of dread or impending doom.


The sooner you can get to hospital, the better your chances of recovery. Emergency services will send an ambulance or arrange other transport for you – don’t attempt to drive yourself.




What are some other causes of chest pain?


It is important to keep in mind that chest pain is a symptom of an underlying problem, ranging from insignificant to very serious. When you experience chest pain, even if you have none of the other symptoms mentioned above, you should still contact your doctor – especially if you also have a fever or cough, or the pain lasts for more than 24 hours.  Some other causes of chest pain are:


  • angina (different from a heart attack because the arteries are not completely blocked, and it usually doesn’t permanently damage the heart)
  • anxiety or panic attack
  • aortic dissection (a tear in the lining of the aorta - the body's main artery that comes directly from the heart)
  • respiratory illnesses such as pneumothorax, pneumonia and pleurisy
  • benign chest wall pain (a sharp, ‘catching’ pain that often occurs in the middle of a breath, but quickly disappears)
  • heartburn due to gastro-oesophageal reflux disease (GORD)
  • mitral valve prolapse (a rare abnormality that may or may not cause pain)
  • peptic ulcers
  • pericarditis (inflammation of the membrane that encloses and protects the heart)
  • pulmonary embolism (a blood clot in the lung)
  • recent injuries such as fractured ribs and strained muscles.
  • a symptom of the onset of shingles before the rash occurs




What is the treatment?


The treatment for chest pain depends entirely on the underlying cause. If you have a suspected heart attack, the hospital team will look at your medical history and do a physical examination, and extra tests like an electrocardiogram (ECG). You will also have some blood tests to measure your cardiac enzymes, which will confirm the diagnosis.

Treatment will depend on the amount of damage to your heart that has occurred. You may simply be prescribed blood-thinning medication(s) to increase blood flow through the arteries. You may require a surgical procedure called angioplasty, where a tiny tube is inserted to open up the arteries – or in more serious cases, a cardiac bypass operation.

Long term treatment includes lifestyle modifications such as giving up smoking, weight reduction, moderate exercise and reducing your saturated fat, alcohol and salt intake, as well as ongoing medication.

Other causes of chest pain will require treatment appropriate to the diagnosis. Therapy may include blood-thinning or antihypertensive medications, antibiotics, antacids, asthma relievers and preventers, surgery, or making healthier lifestyle choices. In other words, treatment will be aimed at resolving the underlying problem, rather than just relieving the pain.





More Information

Heart Foundation


Stroke Foundation of NZ Inc




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