Chest Pain: What is it, Symptoms, Causes and Risk Factors, Diagnosis, Treatments | National Heart Centre Singapore (NHCS)
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Chest Pain

Chest Pain - What it is



Chest pain is a common presenting complaint of patients with coronary artery disease. Typical chest pain presents as a dull ache in the central chest which can last for several minutes (usually five to 15 minutes) and is aggravated by physical activity or emotional stress and relieved by rest. It can range from a dull ache to a sharp stabbing or pulling pain. For some patients, the pain can even spread to other body parts, such as the neck or jaw. 

Various ailments can result in chest pain. While it may be caused by life-threatening conditions involving the heart or lungs, it can also arise from other disorders involving the gastrointestinal tract or muscular chest wall. As it may be difficult to determine the exact cause of chest pain, please seek immediate medical help for your chest pain concerns.

Chest Pain - Symptoms

Heart-related chest pain


While chest discomfort is mostly associated with heart disease, it is difficult to correctly attribute the patient’s chest pain to a heart condition. Some general signs of chest pain related to a heart attack or other heart conditions include:

  • Shortness of breath
  • Cold sweats
  • Dizziness or fatigue
  • Nausea or vomiting
  • Pressure or tightness in your chest
  • A deep pain which radiates to your neck, jaw, back and arms — particularly on the left arm
  • Intermittent pain or pain which lasts for a while, especially becoming worse with exertion

Chest Pain - How to prevent?

Chest Pain - Causes and Risk Factors

Chest pain can be also be due to digestive, heart or muscle and bone problems. 

Some examples of heart-related causes of chest pain are: 

Chest Pain - Diagnosis

While chest pain is not always a symptom of a heart attack, it is important for doctors to test for this critical condition first. The doctor may also check for life-threatening lung conditions which may also present with chest pain.
 
Examples for initial diagnostic tests are: 

Chest Pain - Treatments

The treatment for chest pain varies and is based on the underlying cause of your chest pain.

Other procedures and surgeries to treat some dangerous causes of chest pain include:

Chest Pain - Preparing for surgery

Chest Pain - Post-surgery care

Chest Pain - Other Information

A common cause of chest pain is due to heart attack or a sudden cardiac arrest, two heart conditions with various differences.

Comparison between heart attack and cardiac arrest

​Heart Attack 
heart attack icon

Cardiac Arrest
cardiac arrest icon

​A heart attack occurs when there is a sudden obstruction of blood flow in the coronary artery. The part of the heart muscle which does not receive blood would be at risk of injury. Chest pain that lasts longer than 15 minutes and not relieved by rest might signal an impending heart attack. A heart attack can trigger life-threatening arrhythmia, leading to suddencardiac arrest.

​Cardiac arrest occurs when there is a dangerous form of electrical malfunction in the heart. This causes the heart to pump ineffectively, resulting in the inability of vital organs to receive blood and oxygen. A person with sudden cardiac arrest might lose consciousness, collapse suddenly and become pulseless. Without emergency treatment, death usually ensues within minutes.

Symptoms


The symptoms of a heart attack are typically more pronounced. 

  • Severe chest pain or discomfort lasting longer than 15 minutes

  • New onset of chest pain or discomfort at rest or with minimal exertion

  • Shortness of breath

  • Cold sweat, nausea or light-headedness 

Symptoms


Sudden cardiac arrest often occurs without warning symptoms. Occasionally, short-lived warning symptoms might occur.

  • Chest pain

  • Heart palpitations

  • Shortness of breath

  • Light-headedness

What to do

Requires immediate medical attention. Treatment may involve blood-thinning medication and coronary angioplasty (e.g. ballooning or stenting) to quickly unblock the affected coronary artery, allowing blood to flow. In some cases, coronary artery bypass surgery (CABG) may be required. 

What to do

Needs emergency treatment. In the first instance of sudden cardiac arrest, call 995 for an ambulance immediately. Perform cardiopulmonary resuscitation (CPR) and deliver treatment with automated external defibrillator (AED) while waiting for medical help to arrive. By doing so, it increases the person’s chances of survival.

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