Overview

Most chest pain is not a heart emergency — muscle strains, rib-cartilage irritation and heartburn are common causes. But some chest pain patterns are emergencies, and the most important step is knowing the difference.

This page is a safety guide, not a diagnosis. If you have any of the urgent patterns below, call your local emergency number immediately (911 in Canada) rather than waiting or searching for answers.

When to Call Emergency Services Now

Call 911 (or your local emergency number) if chest pain or discomfort:

Feels tight, heavy, squeezing or pressing, and does not ease with rest
Spreads to the arm, neck, jaw, back or stomach
Is accompanied by shortness of breath, sweating, nausea, lightheadedness or fainting
Comes with a fast or irregular heartbeat and feeling unwell
Is new, severe or different from anything you have felt before

For both men and women, chest pain or discomfort is the most common heart attack sign, but women can experience a heart attack without chest pain — shortness of breath, pressure or pain in the jaw, upper back or upper abdomen, lightheadedness or extreme fatigue can also be warning signs.

Chest Wall Pain Looks Different

Musculoskeletal chest pain — from the pectoral muscles, rib-cartilage joints or ribs — usually has some of these features:

It is reproducible by pressing on the spot
It worsens with specific movements like pushing, twisting or coughing
It came on after a known physical cause, like a heavy press or a fall
It is not accompanied by shortness of breath, sweating or nausea

Those features are helpful clues, but they are not proof that the cause is safe. Chest pain deserves the same caution as any new, unexplained symptom.

After the Emergency Is Ruled Out

If a clinician has confirmed your chest pain is musculoskeletal, common patterns include:

Chest wall pain — muscle or rib-cartilage irritation
Pain near the armpit — pec tendon or muscle irritation
Pec strain or tear — from a forceful or loaded effort
Costochondritis — rib-cartilage irritation at the breastbone
Rib fracture and bruised rib — after trauma with breathing-related pain

Questions to Ask Yourself (for Non-Urgent Situations)

Is the pain reproducible by pressing or specific movements?
Did it start after a known physical cause?
Is it worse with breathing, coughing or twisting?
Do I have any shortness of breath, sweating, nausea or pain spreading beyond the chest?
If any urgent feature is present, do not wait — call for help.

What to Do

If an urgent pattern is present, call 911 or your local emergency number now
If you are unsure, seek medical advice rather than assuming a muscle cause
Once a musculoskeletal cause is confirmed, manage the activity and follow the related guides

References

NHS. "Heart attack — immediate action required." https://www.nhs.uk/content-widgets/health-a-to-z/heart-attack
Heart & Stroke Foundation of Canada. "Emergency signs and actions." https://www.heartandstroke.ca/-/media/1-stroke-best-practices/resources/patient-resources/signs-of-stroke-and-heart-attack-bookmark-en.pdf
AAFP. "Chest Wall Pain." American Family Physician. 2021. https://www.aafp.org/pubs/afp/issues/2021/0700/p73.pdf

This information is for education only and is not a medical diagnosis. InjuryAtlas does not replace an assessment by a qualified health professional. If you have severe pain, visible deformity, numbness, loss of function, or symptoms that are getting worse, seek medical care promptly.

Chest Pain: When It Needs Urgent Care