Chest pain has many potential causes, ranging from serious heart conditions to digestive issues, muscle strain, and anxiety. While any persistent chest pain deserves medical attention, most cases are not heart-related. According to the Centers for Disease Control and Prevention, heart disease remains the leading cause of death in the United States, making it essential to understand which symptoms require immediate attention and which may have less serious origins.
This guide covers the most common causes of chest pain, how to distinguish heart attack symptoms from other conditions, and when preventive screening can provide peace of mind.
What causes chest pain?
Chest pain originates from various body systems, including your heart, lungs, digestive tract, muscles, and nerves. The sensation can range from sharp and stabbing to dull pressure, and the location and duration often provide clues about the underlying cause.
Heart-related causes include coronary artery disease, angina (reduced blood flow to the heart), pericarditis (inflammation of the heart’s protective lining), and heart attack. These conditions typically produce pressure, tightness, or squeezing sensations rather than sharp pain.
Non-cardiac causes account for roughly half of all emergency department visits for chest pain. These include acid reflux and GERD (the most common cause overall), musculoskeletal strain, anxiety and panic attacks, and respiratory conditions like pneumonia or pleurisy.
Understanding the difference between these causes can help you respond appropriately—but when in doubt, seek medical evaluation. A CT heart scan can detect early signs of coronary artery disease before symptoms become severe.
How to tell the difference: Cardiac vs non-cardiac chest pain
One of the most common questions people ask is: “How do I know if my chest pain is serious?” This comparison table helps you understand the key differences between heart-related chest pain and other common causes.
| Characteristic | Heart-Related | Anxiety/Panic | GERD/Heartburn | Musculoskeletal |
|---|---|---|---|---|
| Pain Quality | Pressure, squeezing, heaviness | Sharp, stabbing | Burning sensation | Aching, tender to touch |
| Location | Center or left chest, may radiate | Localized, may move | Behind breastbone | Specific spot you can point to |
| Duration | 5+ minutes, persistent | 5-20 minutes | Variable, can be hours | Days to weeks |
| Common Triggers | Physical exertion, stress | Sudden stress or worry | After meals, lying down | Movement, deep breathing |
| What Helps | Rest may NOT help | Calming down, breathing | Antacids, sitting upright | Changing position |
| Risk Factors | Age 40+, family history, smoking | Any age, history of anxiety | Common all ages | Recent injury, coughing fit |
Important: While this table provides general guidance, any persistent chest pain should be evaluated by a healthcare professional. If you’re experiencing chest pain lasting more than five minutes, especially with shortness of breath or sweating, call 911 immediately.
Am I having a heart attack?
Recognizing heart attack symptoms quickly can save your life. According to the American Heart Association, calling 911 immediately when experiencing warning signs is critical—emergency responders can begin treatment en route and are equipped with life-saving equipment.
Classic heart attack symptoms include:
- Chest pressure, squeezing, or tightness lasting more than a few minutes
- Pain radiating to the arm, shoulder, neck, jaw, or back
- Shortness of breath with or without chest discomfort
- Cold sweats, nausea, or lightheadedness
Heart Attack Symptoms in Women: What You Need to Know
Women often experience different symptoms than men. The Centers for Disease Control and Prevention reports that women more commonly experience symptoms that can be subtle and easily dismissed:
Common symptoms in women:
- Unusual fatigue that doesn’t match your activity level
- Sleep disturbances or sudden insomnia
- Back pain between shoulder blades
- Jaw or tooth pain without an obvious cause
- Nausea or indigestion that feels different than usual
- Shortness of breath during normal activities
- Anxiety or sense of impending doom
- Chest discomfort that may feel like pressure but isn’t the classic “crushing” pain
Why the difference? Women’s blood vessels are smaller, and blockages may occur in smaller arteries (microvascular disease) that don’t show up on traditional testing. Additionally, hormonal factors can influence how symptoms present.
Critical fact: Studies show women are more likely to delay seeking treatment because they don’t recognize these symptoms as cardiac-related. If you experience unusual fatigue, back pain, or other symptoms listed above—especially if you have risk factors like high blood pressure, diabetes, or family history—don’t wait. Call 911.
Learn more about early detection strategies for heart disease and consider preventive screening if you have risk factors.
If you experience these symptoms, do not drive yourself to the hospital. Call 911 immediately, even if you are uncertain whether it is a heart attack.
Understanding your risk by age
Chest pain causes and concerns vary significantly by age group. Understanding what’s most common for your age can help you make informed decisions about when to seek care and whether preventive screening is appropriate.
Under 30
Lower cardiac risk, but stay informed
Most Common Causes:
- Anxiety and panic attacks
- Muscle strain from exercise
- Costochondritis (chest wall inflammation)
- Acid reflux and GERD
When to Be Concerned:
- Family history of early heart disease (before age 55 in men, 65 in women)
- Congenital heart conditions
- Use of certain substances
- Prolonged symptoms despite treatment
Prevention Focus:
- Establish healthy lifestyle habits now
- Know your family cardiac history
- Manage stress and anxiety
- Avoid smoking and excessive alcohol
Ages 30-50
Transition period – cardiac risk begins
Most Common Causes:
- Early coronary artery disease
- High blood pressure complications
- Stress and anxiety (work, family)
- GERD and digestive issues
When to Be Concerned:
- Multiple risk factors (diabetes, high cholesterol, smoking)
- Chest pain during physical exertion
- Family history of heart disease
- Unexplained shortness of breath
Screening Recommendations:
- Consider baseline heart scan if you have risk factors
- Annual cholesterol and blood pressure checks
- Blood sugar screening (especially if overweight)
- Discuss coronary calcium scoring with your doctor
In your 40s with risk factors? A preventive heart scan can detect arterial plaque before symptoms develop.
Age 50 and Over
Highest risk period – vigilance essential
Most Common Causes:
- Coronary artery disease and angina
- Heart attack risk increases significantly
- Pericarditis and myocarditis
- GERD (very common)
- Musculoskeletal pain
Red Flags Requiring Immediate Care:
- Any new chest pain pattern
- Pain during minimal exertion
- Worsening angina frequency
- Chest pain with accompanying symptoms
Essential Screening:
- CT heart scan strongly recommended
- Regular stress tests if symptomatic
- Annual comprehensive cardiac evaluation
- Manage all risk factors aggressively
Medicare coverage: Some preventive cardiac screenings may be covered. Check with your provider or contact us to learn about affordable self-pay screening options.
Can anxiety cause chest pain?
Yes, anxiety and panic attacks are among the most common causes of non-cardiac chest pain. When your body’s “fight or flight” response activates, the release of adrenaline and cortisol creates physical symptoms including chest tightness, rapid heartbeat, and muscle tension.
Anxiety-related chest pain typically feels sharp or stabbing, comes on suddenly during stressful situations, and improves within 10 to 20 minutes. In contrast, heart attack pain usually builds gradually and does not improve with rest or changes in position.
For patients with established coronary artery disease, the relationship between stress and chest pain becomes more complex. Mental stress-induced myocardial ischemia (MSIMI) can cause chest pain when psychological stress increases the heart’s oxygen demand. This underscores the importance of understanding your baseline heart health.
If you experience frequent anxiety-related chest pain, discuss both stress management techniques and coronary calcium screening with your doctor to rule out underlying cardiac issues.
Can gas cause chest pain?
Gas trapped in the digestive tract can absolutely cause chest pain and discomfort. When gas accumulates in the upper intestinal tract, it can create sharp, stabbing sensations in the chest that may be alarming.
Key differences between gas pain and heart-related chest pain:
- Gas pain often improves with movement, burping, or passing gas
- Changing positions typically helps gas pain but does not relieve heart attack symptoms
- Gas-related discomfort frequently follows meals or specific foods
Constipation can contribute indirectly by trapping gas in the digestive system. Staying hydrated, eating fiber-rich foods, and maintaining physical activity help keep digestion moving and reduce gas buildup.
Other common causes of chest pain
Chest pain when swallowing
Pain while swallowing often points to esophageal conditions. Esophagitis (inflammation of the esophagus), GERD, and esophageal spasms can all cause significant chest discomfort. Chronic acid reflux deserves attention because, according to the National Institutes of Health, untreated GERD may increase the risk of esophageal complications over time. Work with your healthcare provider to manage symptoms effectively.
Chest pain when lying down
Position-dependent chest pain has several potential causes. Acid reflux typically worsens when lying flat, as gravity no longer helps keep stomach acid down. Pericarditis (inflammation around the heart) often produces sharp pain that worsens when lying down and improves when sitting forward. Heart conditions like myocarditis or certain lung problems can also cause position-related discomfort.
How to tell if chest pain is muscular
Musculoskeletal chest pain—from strained intercostal muscles, costochondritis, or injury—has distinctive characteristics. The pain typically worsens with specific movements, breathing deeply, or pressing on the affected area. Unlike heart-related pain, muscular chest pain often has a clear trigger (exercise, lifting, coughing) and responds to rest and anti-inflammatory measures.
Can dehydration cause chest pain?
Dehydration can indirectly contribute to chest discomfort. As you become dehydrated, blood volume decreases, forcing your heart to work harder to maintain circulation. This increased workload can cause palpitations, rapid heartbeat, and chest sensations. Research indicates that chronic dehydration affects a significant portion of the population—staying properly hydrated supports overall cardiovascular function.
When should you worry about chest pain?
Certain chest pain characteristics require immediate emergency care:
- Pain lasting more than five minutes that does not improve with rest
- Crushing, squeezing, or pressure sensation in the chest
- Pain spreading to the arm, jaw, neck, or back
- Accompanying symptoms like shortness of breath, sweating, nausea, or dizziness
- Pain occurring with known heart disease that feels different or more severe than usual
Even if chest pain resolves on its own or has an obvious non-cardiac cause, consider discussing it with your healthcare provider. Recurring chest pain—even when mild—can indicate conditions worth investigating. Many people with early coronary artery disease have no symptoms until significant blockage develops.
How to check your heart health
Beyond responding to symptoms, proactive heart health monitoring helps identify problems before they become emergencies. The American Heart Association notes that approximately 47% of Americans have at least one major risk factor for heart disease (high blood pressure, high cholesterol, or smoking).
When you visit a healthcare provider about chest pain, they typically evaluate your symptoms, medical history, and risk factors. Diagnostic approaches may include an electrocardiogram (ECG), blood tests for cardiac markers, stress testing, or imaging studies.
CT heart scan
A coronary calcium scan (also called a heart CT scan) detects calcium buildup in the coronary arteries—an early indicator of atherosclerosis and coronary artery disease. This quick, non-invasive screening takes approximately five to fifteen minutes, requires no fasting or special preparation, and uses no contrast dye.
Your calcium score provides insight into your cardiovascular risk:
- Score of 0: No detectable calcium; low risk of coronary artery disease
- Score of 1-99: Mild buildup; moderate risk
- Score of 100+: Moderate to significant buildup; increased risk
Preventive screening is particularly valuable for adults over 40 with risk factors including family history of heart disease, high cholesterol, high blood pressure, diabetes, or smoking history. Learn more about what to expect during a heart scan and whether screening is appropriate for you.
Take control of your heart health today. Early detection gives you the power to prevent serious problems.
Finding a heart scan near you
Craft Body Scan offers convenient CT heart scans at multiple locations across the United States. These preventive screenings help identify coronary artery disease in its early stages—when lifestyle changes and treatment can have the greatest impact.
Current Craft Body Scan locations include Charlotte, Raleigh, and Mooresville in North Carolina; Nashville, Tennessee; Tampa, Florida; Tulsa, Oklahoma; Austin and Elgin in Texas; and Columbus, Ohio.
Understanding your heart health provides valuable peace of mind. If you have questions about chest pain, risk factors, or whether preventive screening is right for you, reach out to schedule a consultation or learn more about our heart and lung scan options.
Frequently asked questions
Is chest pain always serious?
No—most chest pain is not caused by heart problems. Studies show only about 6% of emergency room visits for chest pain involve life-threatening cardiac issues. Common non-serious causes include heartburn, muscle strain, and anxiety. However, because chest pain can signal dangerous conditions, any persistent or concerning chest pain should be evaluated by a healthcare provider.
What does non-cardiac chest pain feel like?
Non-cardiac chest pain is often sharp, brief (lasting seconds to minutes), and localized to one specific spot. It may improve with movement, antacids, or changes in position. Pain you can point to with one finger is less likely to be heart-related, though any persistent chest pain warrants medical evaluation.
Should I get my heart checked after occasional chest pain?
If you experience recurring chest pain—even if mild or infrequent—discussing it with your doctor is wise. This is especially important if you have risk factors like high blood pressure, high cholesterol, diabetes, smoking history, or family history of heart disease. Preventive screenings like coronary calcium scans can detect arterial buildup before symptoms become serious.
What tests can detect heart problems before symptoms appear?
A coronary calcium score test (CT heart scan) detects calcium buildup in heart arteries before symptoms develop. This painless 10-15 minute screening is recommended for adults over 40 with intermediate risk factors. Other preventive assessments include blood pressure monitoring, cholesterol panels, and blood glucose screening.
