When Chest Pain Is an Emergency — And When It Isn't

Chest pain sends more than 8 million Americans to the emergency room every year. Most of them are not having a heart attack — but the ones who are need treatment within minutes, not hours.

Classic cardiac chest pain is usually described as pressure, squeezing, or heaviness rather than a sharp stab. It sits behind the breastbone, often radiates to the left arm, jaw, or back, and gets worse with exertion. It's frequently accompanied by shortness of breath, nausea, or a cold sweat.

Pain that is sharp, stabbing, changes with breathing, or reproducible when you press on the chest wall is much more likely to be musculoskeletal or related to the lining of the lungs. That doesn't mean it should be ignored, but it usually isn't an emergency.

The rule I give my patients: if new chest discomfort lasts more than a few minutes, comes on with activity, or is accompanied by shortness of breath or lightheadedness, call 911. Do not drive yourself. Chew an aspirin while you wait.