Is this your symptom?
- Pain or discomfort in the chest (front or back)
- The chest includes from the top to the bottom of the rib cage
- Care guide does not cover pain due to a chest injury
Causes of Chest Pain
There are many problems that can cause chest pain. The pain can range from a sharp stab to a dull ache. It can feel crushing, burning or tearing or can be like an ache or heavy feeling in the chest. Sometimes, the pain goes up the neck, and/or into the jaw. It can also go into the back or down one or both arms. The most serious causes can be life-threatening. They can often be treated successfully when diagnosed quickly. It's important to seek help right away.
Less Serious Causes
- Muscle Overuse. Chest pain can follow hard work-outs or activities (such as throwing a baseball). Lifting (such as weights) or upper body work (such as digging) can also cause it. This type of muscle soreness often increases with movement of the shoulders.
- Muscle Cramps. Most brief chest pain, lasting seconds to minutes, is from muscle cramps (often the ribs). These fleeting pains can also be caused by a pinched nerve. These chest wall pains are harmless. Brief muscle cramps are also the most common cause of recurrent chest pains.
- Coughing. Chest pain often happens with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm.
- Asthma. People with active asthma often have chest tightness. They may refer to this as chest pain. They also get chest pain when they have lots of coughing.
- Heartburn is due to reflux of stomach contents. It usually causes a burning pain under the lower sternum (breastbone).
- Caffeine. A rapid and pounding heart beat may feel like chest pain. Too much caffeine (in energy drinks, colas and coffee) is a common cause. Drugs taken for ADHD also can cause a fast heartbeat. So can illegal drugs, such as cocaine.
More Serious Causes
- Chest Wall Injury. Blunt trauma, such as falling onto something or a blow to the chest (thrown object or impact with another person during sports) usually just causes a bruised rib. Sometimes, it causes a broken rib (fracture). Pain from broken ribs may last for several weeks before starting to ease.
- Heart Disease (serious). Heart disease is a common cause of chest pain in adults. Chest pain that only occurs with exercise could have a cardiac (heart) cause. It is important to seek care right away if this happens. Life-saving treatment is important at this stage, before the condition gets worse and becomes life-threatening. Heart pain can also occur if the heart beat feels too fast, too slow or with an uneven beat. Sometimes a change in heart rate or rhythm only lasts for a few minutes and does not cause any other symptoms. But it can occur with dizziness, fainting, chest pain or breathing trouble. See your doctor if any of these occur.
- Pleurisy (serious) is an infection near the surface of the lung that causes pain as you take a breath. It can happen with pneumonia. If the infection involves the lung's surface, that area of the chest will hurt.
- Pulmonary Embolus (serious) occurs when a clot from somewhere in the body (often the legs) travels through the blood stream and gets trapped in the lungs. A large clot can be life-threatening. Symptoms include breathlessness, chest pain and coughing up blood.
Pain Scale
- Mild: you feel some pain, but it does not keep you from any normal activities. Work, activities and sleep are not changed.
- Moderate: the pain keeps you from doing some normal activities. It may wake you up from sleep.
- Severe: the pain is very bad. It keeps you from doing all normal activities.
When to Call for Chest Pain
Call 911 Now
Go to ER Now
Call Doctor or Seek Care Now
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Contact Doctor Within 24 Hours
Contact Doctor During Office Hours
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Self Care at Home
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Call 911 Now
- Severe constant chest pain (you are not able to move or do anything)
- Severe trouble breathing (struggling for each breath, can barely speak)
- Passed out (fainted) or feel like you might pass out
- Confused
- Bluish lips or face or you appear very pale
- Heavy sweating
- A tearing feeling in the chest, abdomen or back
- Pain that goes into the neck, jaw or arm
- Not moving or too weak to stand
- You think you have a life-threatening emergency
Go to ER Now
- Heart is beating:
- very fast (palpitations or pounding heart), or
- very slowly, or
- feels like there are extra or missed beats (not a steady beat)
- Chest pain lasts more than 5 minutes
- Coughed up blood
Call Doctor or Seek Care Now
- You have known heart disease
- The chest pain you get from your known heart disease feels different. Examples: it comes on more easily, is worse, lasts longer than usual or does not go away with usual treatment.
- New chest pain that happens when you walk or exercise; it goes away when you rest
- Trouble breathing, but not severe
- Taking a deep breath makes the pain worse
- Fever or chills; feeling hot or shivery
- Pain happened after a direct blow or injury to the chest
- You feel weak or very sick
- You think you need to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Cause of chest pain is not clear. Not due to coughing, sore muscles, heartburn or other clear cause.
- Rash or blisters in the chest area
- You think you need to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Chest pains only occur with hard exercise (such as running)
- Sore chest muscles last more than 7 days
- Heartburn lasts more than 2 days on treatment
- Mild chest pains happen often
- You have other questions or concerns
Self Care at Home
- Normal chest pain from coughing or sore muscles
- Normal chest pain from heartburn
Care Advice for Stomach Pain
What You Should Know About Stomach Pain:
- Mild stomach pain can be caused by something simple. It could be from gas pains or eating too much.
- Sometimes, stomach pain signals the start of a viral infection. This will lead to vomiting or loose stools.
- Watching your child for 2 hours will help tell you the cause.
- Here is some care advice that should help.
Lie Down:
- Have your child lie down and rest until feeling better.
Clear Fluids:
- Offer clear fluids only (such as water, flat soft drinks or half-strength Gatorade).
- For mild pain, offer a regular diet.
Prepare for Vomiting:
- Keep a vomiting pan handy.
- Younger children often talk about stomach pain when they have nausea. Nausea is the sick stomach feeling that comes before they throw up.
Pass a Stool:
- Have your child sit on the toilet and try to pass a stool.
- This may help if the pain is from constipation or diarrhea.
- Note: for constipation, moving a warm wet cotton ball on the anus may help.
Do Not Give Medicines:
- Any drug (like ibuprofen) could upset the stomach and make the pain worse.
- Do not give any pain medicines or laxatives for stomach cramps.
- For fever higher than 102° F (39° C), acetaminophen (such as Tylenol) can be given.
What to Expect:
- With harmless causes, the pain is most often better or gone in 2 hours.
- With stomach flu, belly cramps may happen before each bout of vomiting or diarrhea. These cramps may come and go for a few days.
- With serious causes (such as appendicitis), the pain worsens and becomes constant.
Call Your Doctor If:
- Pain becomes severe
- Constant pain lasts more than 2 hours
- Mild pain that comes and goes lasts more than 24 hours
- You think your child needs to be seen
- Your child becomes worse
Extra Help - Worried Stomach:
- Help your child talk about events that trigger the stomach pain. Talk to your child about how to cope with these the next time around.
- Help your child worry less about things she can't control.
- To treat the pain, help your child get very relaxed. Lying down in a quiet place and taking slow deep breaths may help. Make the belly go up and down with each breath. Then try to relax all the muscles in the body. Think about something pleasant. Listening to audios that teach how to relax might also help.
- Make sure your child gets enough sleep.
- Make sure that your child doesn't miss any school because of stomach pains. Stressed children tend to want to stay home when the going gets rough.
- Caution: your child should see her doctor for an exam. Do this before concluding frequent stomach pains are from worrying too much.

