I have chest pain. What could it be?

In brief

In brief

  • Chest pain or pressure can be related to muscles, oesophagus, stomach, heart, lungs or stress.
  • See your GP to find out what’s causing your chest pain. 
  • Call immediately if you have chest pain or pressure with any of these symptoms:
    • The pain or pressure starts suddenly during physical activity or stress. The pain does not go away when you sit quietly. 
    • You are also nauseous and sweating.
    • You are breathing faster and are short of breath.
    • You have a fever. 
  • Dutch healthcare practices in general may differ from what you are used to in your home country. Learn more.
What is it?

What can you feel if you have chest pain?

Pain in or on your chest can be felt in many areas, for example between your ribs, behind your breastbone (sternum) or at the bottom of your breastbone.

The pain can be on 1 side, on both sides, or in the middle of your chest.

The pain can start suddenly or come on slowly.
The pain can be constant. Or you can feel pain now and then: during physical activity, when you cough, in a certain position or when you move a certain way, or when you press on the sore area.

Having chest pain might worry you. It could have something to do with your heart. But there are also many other causes.

See your GP to find out the cause.

Causes

What could cause chest pain?

Chest pain can be related to:

Muscles and ribs

You could feel pain:

  • when you press on the sore area
  • when you move a certain way 
  • when you cough
  • when you lie on the sore area

This pain is usually caused by strained muscles (in Dutch) between the ribs.
For example, because you have spent several days coughing.
Or because you have done hard physical work for a long time (painting, bricklaying, cleaning).

You can also feel a stabbing pain where the ribs attach to the breastbone. There are muscles, tendons and cartilage there, which can be irritated. This could be Tietze syndrome (in Dutch).

Stomach and oesophagus

Pain behind your breastbone can also be caused by stomach acid in your oesophagus (also called the food pipe or gullet). You feel the pain a few hours after eating, especially when you lie down or bend forward.
The pain often decreases after eating a sandwich or drinking a glass of milk. Or after taking medication for heartburn (acid reflux).

Stress, anxiety or depression

A tight feeling in your chest could be caused by stress, a panic attack or anxiety.
You may also feel chest pain if you have depression (in Dutch).  

Heart

If you have narrowed coronary arteries, your heart may receive too little oxygen when you are very active or very stressed. This is called angina (in Dutch).
The pain soon disappears if you sit or lie down quietly. It goes away after a few minutes.
If the pain does not go away quickly, it could be a heart attack. Often you will then also be nauseous and sweating.  

A sharp pain in the chest can also be caused by inflammation of the pericardium (the sac that surrounds the heart).
This can start with fever, flu or a cold. The pain sometimes gets worse when you cough, breathe in deeply, or when you lie on your back or your left side. The pain may decrease when you bend forward.

Lungs

Chest pain can also be caused by pneumonia (in Dutch), flu or a bad cold. Breathing and coughing hurt.

Pleurisy is an inflammation of the membranes that surround the lungs, and can cause sharp pain. The pain is constant and gets worse when you breathe in deeply or move a certain way. 

Pain in the chest cavity can also be caused by a pulmonary embolism. In this case there is a blood clot in a blood vessel. This stops oxygen from getting to a part of the lung.
This mainly causes pain when taking a deep breath. Other symptoms are shortness of breath, breathing faster, tiredness or coughing a lot.

A collapsed lung can also cause chest pain. The pain occurs suddenly and you are short of breath. 

Skin

Pain (or itching) on 1 side of the chest could be caused by shingles (in Dutch). You will then also have spots and blisters.

When to call

When to see your GP for chest pain?

Make an appointment with your GP if you have chest pain. Your doctor will determine the cause of the pain.

Call your GP or the out-of-hours service (huisartsenpost) immediately in these cases:

  • You suddenly feel pressure in your chest during physical activity. The feeling does not go away when you sit quietly.
  • You feel a sharp pain in your chest and breathing remains difficult and painful.
  • You are breathing faster and are short of breath. 
  • You have a fever. 

Do you have pain or a feel a heavy pressure or have a tight feeling in your chest, and are you sweating and nauseous? Then call 112.

More information

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