Chest Pain

Chest pain isn't always a heart attack, but don't ignore it. Learn causes, warning signs, and when to call 000 & steps to lower your risk today.

Dr. Louis J Sisk

BSc(Hons) MBChB MRCS(Glasg) MTrauma

Published: August 23, 2025

What You Need to Know - The Basics

Chest pain can be a sign that something might be wrong with your heart.

The main things to know:

You might feel a tightness, pressure, squeezing, heaviness, or burning in your chest.
It can happen to anyone, not just older adults.
Chest pain can be serious, but many causes are treatable.
Not all chest pain comes from the heart — indigestion (reflux) and muscle strain are common non-heart causes.

When to see a doctor immediately:

Call 000 (Australia) if chest pain comes with trouble breathing, sweating, feeling sick, fainting, or pain in your arm, neck, jaw or back. These can be signs of a heart attack and need urgent care. [4][6]

Overview

Chest pain is a common reason to see a GP or visit the emergency department because it can sometimes be linked to heart disease, especially coronary heart disease (CHD). When the heart muscle doesn’t get enough blood, you may feel angina — a heavy or tight feeling in the chest. Other important causes include inflammation around the heart (pericarditis), problems with the main artery (aortic dissection), or a blood clot in the lungs (pulmonary embolism). These conditions can feel similar, which is why getting checked is important. [1][2]

Statistics and Prevalence in Australia

Around 600,000 adults in Australia live with CHD (about 3% of adults).
More than 4 million Australians live with some form of cardiovascular disease.
Risk is generally higher in men, older adults, people from lower socioeconomic backgrounds, and Aboriginal and Torres Strait Islander peoples.

These numbers underline why chest pain should be taken seriously and assessed early. [1][2][3]

Symptoms and Clinical Presentation

Chest pain can feel different from person to person.

Common symptoms:

A pressure, heaviness, tightness or squeezing in the middle of the chest.
Pain that may spread to the arm, neck, jaw, back, or shoulder.
Shortness of breath, sweating, nausea, or dizziness alongside the pain.

Other ways chest pain can present:

Some people — often women, older adults, and those with diabetes — may notice unusual tiredness, indigestion-like feelings, breathlessness, or back/shoulder pain instead of obvious chest pressure. If it feels wrong, get help. [2]

Red flags — call 000:

Sudden, severe chest or back pain.
Fainting, marked breathlessness, or a strong sense that “something is very wrong”. [2]

Causes and Risk Factors

Heart-related causes

Angina or heart attack: reduced blood flow to the heart muscle.
Pericarditis: inflammation around the heart.
Abnormal heart rhythms or heart valve problems.

Non-heart causes

Reflux/indigestion (GERD) or oesophageal spasm.
Lung conditions: infection (pneumonia), pulmonary embolism, or a collapsed lung.
Muscle and joint pain (e.g. costochondritis), often tender to touch or worse with movement.
Anxiety or panic, which can cause chest tightness and a racing heart. [2]

Risk factors for heart-related chest pain

Smoking, high blood pressure, high cholesterol, diabetes, kidney disease, family history of heart disease, older age, obesity, and low physical activity. Managing these helps lower risk over time. [2]

Diagnosis

Doctors follow clear steps to quickly work out whether chest pain is from the heart and whether urgent treatment is needed.

What to expect:

Questions and examination: when it started, what it feels like, what brings it on or eases it, and your medical history.
Heart tracing (ECG): a quick test to look at your heart’s electrical activity — usually done within minutes in urgent settings.
Blood tests (including troponin) to check for heart strain or damage. These may be repeated after a few hours because early results can be normal even if a problem is developing.
Other tests if needed: a chest X-ray, heart ultrasound (echocardiogram), or scans to look at the lungs or heart arteries. [4][5]

Doctors also use risk tools to decide whether you can go home with advice, need observation with repeat tests, or require treatment straight away. [5][6]

Treatment Options in Australia

If the heart is the cause

You may receive medication to thin the blood (e.g. aspirin), protect the heart, and relieve pain.
Some people need an urgent procedure to open a blocked artery (a stent).
Oxygen is given only if your oxygen level is low. [4][5]

If it’s not the heart

Reflux/indigestion: acid-reducing medicines and diet changes.
Muscle/joint pain: simple pain relief, gentle movement, and time.
Lung conditions: targeted treatment (e.g. antibiotics for infection, blood thinners for a clot).

Costs and access

Essential tests and medicines are supported through Medicare and the Pharmaceutical Benefits Scheme (PBS). Your care team will discuss options and costs with you. [6]

Living with Chest Pain

Day-to-day management

Follow your plan: take medicines as prescribed.
Know your warning signs: if pain returns or changes, especially with breathlessness, fainting, or spreading pain, call 000.
Keep your follow-up appointments and complete any recommended tests.
If a heart cause was found, cardiac rehabilitation (exercise, education, support) helps recovery and reduces future risk. [2]

Self-care that helps

Don’t smoke (get support to quit if you do).
Be active most days (your team will advise what’s safe for you).
Eat a heart-healthy diet: more vegetables, fruit, whole grains; fewer ultra-processed foods.
Focus on sleep and stress management (simple breathing or relaxation techniques).
Know your numbers: blood pressure, cholesterol, blood sugar — check with your GP. [2]

Important: With the right care and lifestyle steps, most people can live full, active lives after chest pain.

Prevention

You can reduce your risk of heart-related chest pain by tackling things you can change:

Quit smoking and avoid second-hand smoke.
Move regularly: aim for about 150 minutes of moderate activity each week (if appropriate for you).
Choose a balanced diet rich in plants and whole foods.
Keep alcohol within recommended limits.
Work with your GP to manage blood pressure, cholesterol, and diabetes.

Regular check-ups help catch problems early. [2]

Key Takeaways

Chest pain is common and not always from the heart, but it should never be ignored.
Call 000 if pain is severe, new, or comes with worrying symptoms like breathlessness or spreading pain.
Early checks — ECG, blood tests, and sometimes scans — help find the cause and guide treatment.
Many causes are treatable, and support is available through Medicare/PBS in Australia.
Lifestyle steps and follow-up care make a real difference to your long-term health. [4][6]

You might also be interested in:

High Blood Pressure — Understanding causes, symptoms, and management
Heart Attack — Recognising symptoms and what to do
Heart Failure — Managing symptoms and treatment options