Diagnosis
Chest pain doesn't always mean that you're having a heart attack. But that's what emergency medical help usually tests for first because it can be life-threatening. Your healthcare professionals also will check for life-threatening lung conditions — such as a collapsed lung or a blood clot in the lung.
Immediate tests
Some of the first tests done to diagnose the cause of chest pain are:
- Electrocardiogram (ECG or EKG). This quick test shows how the heart is beating. The test can tell if you have had or are having a heart attack. Sticky patches with sensors on them go on the chest and sometimes the arms and legs. Wires connect the sensors to a computer, which prints or displays results.
- Blood tests. Certain heart proteins and other substances slowly leak into the blood after heart damage from a heart attack. Blood tests can be done to check for these.
- Chest X-ray. An X-ray of the chest shows the condition of the lungs and the size and shape of the heart. A chest X-ray can diagnose pneumonia or a collapsed lung.
- Computerized tomography (CT) scan. A CT scan uses X-rays to create cross-sectional images of specific parts of the body. A CT scan of the chest can spot a blood clot in the lung or find an aortic dissection.
Follow-up tests
Depending on the results from the first tests for chest pain, you may need more testing, which may include:
- Echocardiogram. Sound waves create images of the beating heart. This test shows how blood moves through the heart and heart valves.
- CT coronary angiogram. This test looks at the arteries that supply blood to the heart. It uses a powerful X-ray machine to make images of the heart and its blood vessels. The test is used to diagnose many different heart conditions.
- Exercise stress test. For this test, you walk on a treadmill or ride a stationary bike while a healthcare professional watches the heartbeat. Exercise tests help show how the heart reacts to exercise. If you can't exercise, you might get medicines that affect the heart like exercise does.
- Coronary catheterization. This test can find blockages in the heart arteries. A long, thin flexible tube is inserted into a blood vessel, usually in the groin or wrist, and guided to the heart. Dye flows through the tube to arteries in the heart. The dye helps the arteries show up more clearly on X-ray images and video.
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Treatment
Chest pain treatment depends on what's causing the pain.
Medications
Medicines used to treat some of the most common causes of chest pain include:
- Nitroglycerin. This medicine is given when your healthcare team thinks your chest pain is due to blocked arteries in the heart. It's often taken as a tablet under the tongue. The medicine relaxes heart arteries so blood can flow more easily.
- Blood pressure medicines. Some blood pressure medicines also relax and widen blood vessels. This can ease chest pain related to the heart.
- Aspirin. If healthcare professionals think that your chest pain is related to your heart, you may be given aspirin. The aspirin does not take away the chest pain. But it's part of the treatment for patients who have or may have blockages in the heart arteries.
- Clot-busting drugs, also called thrombolytics. If you are having a heart attack, you may get these medicines. They work to dissolve the clot that is blocking blood from reaching the heart muscle.
- Blood thinners. If you have a clot in an artery going to your heart or lungs, you may get these medicines to prevent future clots.
- Acid-reducing medicines. These medicines reduce stomach acid. They may be suggested if you have heartburn.
- Anti-anxiety medicines. If you're having panic attacks, your healthcare professional may recommend these medicines. Talk therapy, such as cognitive behavioral therapy, also might be recommended.
Surgical and other procedures
Other treatments for some of the most dangerous causes of chest pain include:
- Angioplasty and stent placement. This treatment helps remove a blockage in an artery going to the heart. The doctor inserts a thin tube with a balloon on the end into a large blood vessel, usually in the groin, and guides it to the heart. The balloon expands. This widens the artery. The balloon is deflated and removed with the tube. A small wire mesh tube called a stent is often placed in the artery to keep it open.
- Coronary artery bypass graft surgery (CABG). This is a type of open-heart surgery. During CABG, a surgeon takes a vein or artery from somewhere else in the body. The surgeon uses the blood vessel to create a new path for blood to go around a blocked or narrowed heart artery. The surgery increases blood flow to the heart.
- Emergency repair surgery. You may need emergency heart surgery to repair a ruptured aorta, also called an aortic dissection. It's a life-threatening condition.
- Lung reinflation. If you have a collapsed lung, a healthcare professional may place a tube in the chest to expand the lung.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Preparing for your appointment
You may not have time to prepare. If you're having severe chest pain or new or unexplained chest pain or pressure that lasts more than a few moments, call 911 or emergency medical services.
Don't waste any time for fear of embarrassment if it's not a heart attack. Even if there's another cause for your chest pain, you need to be seen right away.
What you can do
Share the following information with the emergency medical help, if possible:
- Symptoms. Describe your symptoms in detail. Note when they started and if anything makes the pain better or worse.
- Medical history. Tell the healthcare team whether you've had chest pain before and what caused it. Tell them whether you or any close family members have a history of heart disease or diabetes.
- Medicines. Having a list of all the medicines and supplements you regularly take helps emergency care professionals. You might want to prepare such a list in advance to carry in your wallet or purse.
Once you're at the hospital for chest pain, you're usually examined quickly. Based on results from blood tests and a heart monitor, your healthcare professional can quickly know if you are having a heart attack or not.
You or your family may have many questions. If you haven't received the following information, you may want to ask:
- What's the most likely cause of my chest pain?
- Are there other possible causes for my symptoms or condition?
- What kinds of tests do I need?
- Do I need to stay in the hospital?
- What treatments do I need right now?
- Are there any risks associated with these treatments?
- What are the next steps in my diagnosis and treatment?
- I have other medical conditions. How might that affect my treatment?
- Do I have to change my activities after I get home?
- Should I see a specialist?
Don't hesitate to ask more questions.
What to expect from the doctor
A healthcare professional who sees you for chest pain may ask:
- When did your symptoms start? Have they gotten worse over time?
- Does your pain spread to any other parts of your body?
- What words would you use to describe your pain?
- On a scale of 1 to 10, with 10 being the worst, how bad is your pain?
- Do you have dizziness, lightheadedness or trouble breathing?
- Have you vomited?
- Do you have high blood pressure? If so, do you take medicine for it?
- Do you or did you use to smoke? How much?
- Do you use alcohol or caffeine? How much?
- Do you use illicit drugs, such as cocaine?
Dec. 10, 2024