Chest Pain

Sometimes harmless, the feeling of pressure in the chest can also indicate a potentially life-threatening condition that requires quick and appropriate care. Chest pain should never be ignored. When in doubt, immediately call 144 and stay calm (do not drive!).

The most common harmless causes are so-called 'parietal pains', which are pains in the chest wall and are usually of musculoskeletal origin.

There are five serious causes:

• Acute coronary syndrome, more commonly known as a heart attack.
• Pulmonary embolism, or obstruction of one or more arteries that supply the lungs. This blockage is most often caused by a blood clot that travels to the lungs from another part of the body, most often from the legs.
• Aortic dissection. This is a tear in the wall of the aorta along its length. The wall then separates.
• Pneumothorax which corresponds to the presence of air between the chest wall and the lungs.
• Pericarditis which is inflammation of the lining around the heart.

Parietal pains are usually reproducible and worsen with chest movements, but these criteria alone are not sufficient to rule out a more serious condition.

As mentioned above, the feeling of pressure in the chest should be considered a medical emergency.

To determine the cause of chest pain, the doctor will ask you numerous questions:

• Is this the first episode?
• Where exactly is the feeling of pressure located?
• When did the pain start?
• What does this pain feel like, pressure, tight band, heaviness, 'knife stab'?
• What activity worsens or, on the contrary, alleviates the pain?
• Is the pain only in the chest or does it spread to the shoulders, arms, jaw, or back?
• Are you at risk of cardiovascular problems (hypertension, high cholesterol, diabetes, smoking)?
• Are there any other symptoms: sweating, shortness of breath, nausea, weakness?

The answers to these questions will enable the doctor to assess the urgency.

You will find additional information on chest tightness in the article Recognise chest pain that requires emergency medical attention (note: the emergency phone number in Switzerland is 144).

For more information on pulmonary embolism, read the article Pulmonary embolism on the Planete santé website, and for other issues, see these CHUV articles: acute coronary syndrome, aortic dissection, pneumothorax and pericarditis.