How long should I wait for chest pain to go away? A critical guide

Over one-third of patients who seek medical attention for chest pain do not have a cardiac cause, but serious conditions must always be ruled out first. Therefore, it is critical to know how long should I wait for chest pain to go away before seeking immediate medical care.

Quick Summary

If your chest pain is new, severe, or lasts more than a few minutes, especially when accompanied by other symptoms like shortness of breath or arm pain, you must seek emergency medical help immediately instead of waiting for it to subside.

Key Points

• Emergency Action: For any new, severe, or persistent chest pain, call 911 immediately, especially if accompanied by other concerning symptoms like shortness of breath, arm pain, or nausea.

• Do Not Delay: Waiting to see if the pain goes away is dangerous. Cardiac emergencies require rapid diagnosis and treatment to prevent serious complications.

• Know the Warning Signs: Recognize the difference between heart attack symptoms (pressure, squeezing, pain radiating to arms/jaw) and non-cardiac symptoms (sharp, localized pain that changes with position).

• Many Possible Causes: Chest pain isn't always a heart attack; causes range from harmless muscle strain or anxiety to serious issues like pulmonary embolism or aortic dissection.

• Get a Professional Diagnosis: Even if pain subsides, schedule a follow-up with a doctor to determine the underlying cause and ensure there is no hidden risk.

When to seek emergency care immediately

Chest pain should never be taken lightly. Any unexplained chest pain that is sudden, severe, or lasts more than a few minutes warrants immediate medical attention. Calling 911 is the safest course of action, as paramedics can begin preliminary tests and treatment on the way to the hospital, potentially saving precious time in a heart-related emergency.

Call 911 or local emergency services if you experience chest pain with any of the following symptoms:

• A feeling of pressure, tightness, squeezing, or crushing in the chest.
• Pain that radiates to the arms (especially the left), jaw, neck, back, or stomach.
• Shortness of breath or difficulty breathing.
• Cold sweats, nausea, or vomiting.
• Lightheadedness, dizziness, or fainting.
• A rapid or irregular heartbeat.
• A sudden and severe onset of pain that doesn't go away with rest.

Distinguishing heart-related vs. non-heart-related symptoms

It can be challenging to determine if chest pain is cardiac or non-cardiac, as symptoms can overlap. Some clues can help differentiate, but you should not use these to delay emergency treatment. Cardiac pain often feels like pressure and worsens with physical exertion, while non-cardiac pain might be sharp or localized and change with body position.

Cardiac vs. Non-Cardiac Symptom Comparison

Symptom Trait	Likely Cardiac Cause	Likely Non-Cardiac Cause
Onset	Often gradual, or comes on suddenly and lasts for minutes	Can be sudden, often brief, or associated with specific triggers like eating
Sensation	Pressure, squeezing, tightness, fullness, or aching	Sharp, stabbing, burning, or worsens with deep breaths or coughing
Location	Center or left side of chest, may radiate to arm, jaw, or back	Localized to a specific area, may be tender to the touch
Effect of Position	Doesn't usually change with body position	May improve or worsen when changing position, like lying down or bending over
Effect of Activity	Often worsens with exertion and may improve with rest	May change with movement or specific activities, like a muscle strain

Common causes of chest pain

Heart-related causes

Several serious cardiac conditions can cause chest pain. It is vital to be aware of these possibilities and not dismiss symptoms, especially if you have heart disease risk factors.

• Heart Attack: Occurs when blood flow to the heart muscle is blocked.
• Angina: Chest pain or discomfort from reduced blood flow to the heart muscle. Stable angina is predictable and resolves with rest, while unstable angina is a medical emergency.
• Aortic Dissection: A life-threatening tear in the inner layer of the aorta, the body's main artery.
• Pericarditis: Inflammation of the sac surrounding the heart, causing sharp pain that worsens when taking a breath or lying down.

Non-heart related causes

Many other conditions can cause chest pain, often mimicking cardiac symptoms. While generally less life-threatening, these should still be diagnosed by a doctor.

• Gastrointestinal Reflux Disease (GERD): Acid from the stomach washes up into the esophagus, causing a burning sensation known as heartburn.
• Anxiety or Panic Attacks: Intense fear can trigger physical symptoms including chest pain, rapid heartbeat, and shortness of breath.
• Musculoskeletal Issues: Conditions like costochondritis (inflammation of chest wall cartilage), muscle strains, or bruised ribs can cause pain that is tender to the touch.
• Pulmonary Embolism: A blood clot in the lung that requires immediate emergency care.
• Pneumonia or Pleurisy: Lung infections or inflammation of the lining around the lungs can cause sharp, stabbing chest pain that worsens with deep breathing.

What to do while waiting for emergency services

If you have called 911, taking these steps can help manage the situation until professional help arrives:

1. Remain calm and stay as still as possible. Avoid any exertion that might increase strain on your heart.
2. Take an aspirin, but only if directed by a healthcare professional, as it can help reduce heart damage during an attack.
3. Sit or lie down in a comfortable position, ideally with your head elevated slightly.
4. If you have been prescribed nitroglycerin for a heart condition, take it as directed.
5. Pay attention to the pain's characteristics, like its location, intensity, and whether it spreads, to help inform medical professionals upon arrival.

Diagnostic tools for identifying chest pain causes

Doctors use a combination of history, physical exams, and tests to pinpoint the cause of chest pain.

• Electrocardiogram (ECG or EKG): Records the heart's electrical activity to detect if a heart attack is occurring or has occurred.
• Blood tests: Checks for heart proteins and other substances that may be elevated after a heart attack.
• Chest X-ray: Provides images of the heart, lungs, and blood vessels to help identify issues like pneumonia or a collapsed lung.
• CT Scan: Can be used to find a blood clot in the lung or an aortic dissection.
• Stress Test: Monitors heart activity during exercise to see how it responds to exertion.
• Echocardiogram: An ultrasound of the heart to see its pumping function and blood flow.
• Endoscopy: Uses a scope to examine the esophagus and stomach for gastrointestinal causes.

Conclusion: Always err on the side of caution

When it comes to chest pain, delaying care can have serious consequences. The safest approach is to treat any new or unexplained chest pain as a medical emergency until proven otherwise. Even if the pain seems mild, seeking professional medical advice is essential, as early symptoms can be deceptive. For more detailed health information, consult the American Heart Association's resources on heart attack warning signs.

Frequently Asked Questions

How do I know if my chest pain is serious?

If the pain is new, severe, or feels like a crushing pressure that radiates to your arm, jaw, or back, it is a medical emergency. Additionally, if the pain doesn't go away with rest, or is accompanied by cold sweats, shortness of breath, or dizziness, call 911 immediately.

What if my chest pain goes away quickly?

Chest pain that subsides quickly might indicate a less severe issue, such as anxiety or a muscle strain. However, some cardiac conditions, like angina, can also come and go. It is still recommended to see a doctor to get an accurate diagnosis and rule out any underlying heart problems.

Can anxiety cause chest pain that doesn't go away?

Yes, anxiety-induced chest pain can feel persistent and alarming. Panic attacks can cause physical symptoms that mimic a heart attack, including chest tightness, rapid heart rate, and shortness of breath. However, because it is difficult to distinguish, never assume it is just anxiety without a medical professional's evaluation.

Is it better to call an ambulance or drive myself to the hospital?

If you suspect a heart attack, calling an ambulance is the safer option. Paramedics can start treatment on the way and notify the hospital, which can save valuable time upon arrival. Only drive yourself if you have no other choice.

What if my chest pain is caused by acid reflux (GERD)?

GERD can cause a burning sensation in the chest that might be mistaken for heart pain. If you suspect GERD, your doctor may suggest lifestyle changes or medication. However, you should still seek a diagnosis to be certain, especially with new or severe symptoms.

What kind of tests will a doctor run for chest pain?

A doctor will likely start with an electrocardiogram (ECG), blood tests, and a chest X-ray. Depending on the initial findings, they may also perform an echocardiogram, stress test, or CT scan to get a more comprehensive look at your heart and lungs.

How long does anxiety chest pain last?

Anxiety-related chest pain can last anywhere from a few minutes to hours. Unlike stable angina, it might occur even while you are resting. Practicing stress reduction techniques like deep breathing can often help alleviate this pain.