By Fedhealth
Chest discomfort is one of the most common reasons people seek emergency care, yet many dismiss it as fatigue, stress, or indigestion. While occasional shortness of breath or mild chest pain after physical exertion may be harmless, recurring or unexplained discomfort can be an early indicator of angina or coronary artery disease (CAD). Recognising the difference between harmless exertion and concerning symptoms is vital for maintaining heart health.
When Is Chest Discomfort Normal?
Feeling breathless or experiencing a mild ache after strenuous activity, such as carrying heavy groceries or climbing stairs, is not unusual. The discomfort usually fades after rest and is often due to temporary increases in heart rate and oxygen demand. Occasional breathlessness is usually not cause for alarm. However, if these symptoms increase in frequency—such as occurring several times per week—it may indicate an underlying heart condition that requires medical assessment.
Understanding Angina: A Common Cause of Chest Pain
One of the most frequent medical causes of chest discomfort is angina pectoris. This condition occurs when the heart muscle does not receive enough oxygen-rich blood. Angina is a common symptom of coronary artery disease. It occurs when the heart muscle doesn’t get enough blood and oxygen because of arterial narrowing due to fatty deposits known as plaque. The reduced blood flow leads to chest pain and discomfort. Unlike fleeting chest tightness caused by stress or indigestion, angina is a warning sign that raises the risk of a future heart attack.
Symptoms of Angina
Angina symptoms can mimic other conditions, which is why they are often overlooked. Typical warning signs include:
- A squeezing, pressing, or crushing pain in the chest, often behind the breastbone.
- Pain radiating to the shoulders, back, neck, jaw, arms, or even the earlobes.
- Shortness of breath, dizziness, fatigue, or nausea.
According to Cleveland Clinic symptoms are often triggered by activities that increase the heart’s demand for oxygen—such as physical exertion, emotional stress, extreme temperatures, or smoking.
Types of Chest Discomfort
Chest discomfort does not always feel the same for every person. Understanding the different types of sensations can help individuals and doctors distinguish between harmless and potentially dangerous symptoms:
- Sharp or stabbing pain: May be linked to muscle strain, nerve irritation, or lung conditions, but should still be monitored.
- Pressure or squeezing sensation: Often associated with angina or heart-related issues.
- Burning or indigestion-like pain: Sometimes mistaken for acid reflux but can also signal heart disease.
- Dull, persistent ache: Can indicate reduced blood flow to the heart or other chronic conditions.
Being able to describe the type, duration, and triggers of chest pain provides healthcare providers with critical diagnostic clues.
Angina vs Heart Attack: Knowing the Difference
While both angina and heart attacks involve chest pain, they differ in severity and outcome:
- Angina: Pain or discomfort usually comes on with activity or stress and improves with rest or medication such as nitroglycerin.
- Heart Attack (Myocardial Infarction): Pain may be more intense, last longer than a few minutes, and is often accompanied by sweating, nausea, or collapse. Unlike angina, a heart attack occurs when blood flow is completely blocked, causing damage to the heart muscle.
Because symptoms overlap, chest pain should never be ignored. If rest or medication does not ease the discomfort, urgent medical attention is required.
Who Is at Risk?
Although angina is more common in adults over 40, younger individuals should not ignore chest pain. It is often misdiagnosed as heartburn in this age group, leading to delayed treatment. Risk factors for angina include:
- Smoking
- Obesity
- High blood pressure
- Diabetes
- Family history of heart disease
These risk factors contribute to arterial narrowing and reduced blood flow, accelerating the onset of angina and related complications.
Treatment Options
For individuals diagnosed with angina, treatment focuses on relieving symptoms and reducing cardiovascular risk. The most common treatment for angina is nitroglycerin, a medication that relaxes and widens blood vessels, allowing oxygen-rich blood to flow more easily to the heart. Despite its reputation as an explosive in pure form, nitroglycerin is safe and effective in treating chest pain. Other treatment options may include beta-blockers, calcium channel blockers, statins, or in severe cases, procedures such as angioplasty or coronary artery bypass surgery may be necessary.
Lifestyle Changes to Reduce Risk
Dr. Nieca Goldberg, NYC cardiologist, educator, and host of Beyond The Heart podcast, acknowledge that while medication plays a role in managing angina, lifestyle changes are critical in preventing and controlling symptoms. Experts recommend the following:
- Quit smoking – Smoking significantly increases the risk of CAD. Quitting immediately improves heart health.
- Maintain a healthy weight – Obesity strains the heart and raises cholesterol. Weight loss through balanced diet and activity lowers risk.
- Adopt a heart-healthy diet – Choose foods rich in whole grains, fruits, vegetables, lean proteins, and healthy fats supports cardiovascular health. Avoid trans fats, excess sugar, and sodium.
- Exercise regularly – At least 150 minutes of moderate-intensity activity weekly strengthens the heart.
- Manage stress – Stress increases chest pain and can worsen unhealthy habits. Dealing with stress through techniques like meditation or yoga may help.
- Control chronic conditions – Monitor and manage blood pressure, cholesterol, and diabetes with the help of your healthcare provider.
When to Seek Emergency Medical Care
Chest discomfort should never be ignored if it persists, intensifies, or occurs at rest. Seek immediate medical care if you experience:
- Sudden, intense chest pressure or tightness.
- Pain radiating to the arms, neck, jaw, or back.
- Chest pain with shortness of breath, sweating, dizziness, or nausea.
These symptoms may indicate a heart attack. Prompt treatment dramatically improves survival rates and recovery outcomes.
Conclusion
While not all chest discomfort signals a medical emergency, persistent or recurring chest pain is a warning sign that should not be ignored. Angina and coronary artery disease are leading causes of chest pain and increase the risk of a heart attack. By recognising symptoms, understanding risk factors, and making proactive lifestyle changes, individuals can significantly improve heart health.
If you experience unexplained chest pain, consult a healthcare provider promptly. Early detection and management remain the most effective strategies for preventing serious cardiovascular events.
References
- American Heart Association. (2025). Angina. American Heart Association. https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain
- Centers for Disease Control and Prevention. (2024). About heart attack: Symptoms, risk, and recovery. CDC. https://www.cdc.gov/heart-disease/about/heart-attack.html
- Cleveland Clinic. (2025). Angina. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21489-angina
- Fedhealth. (2020). Dealing with stress: Strategies for a healthier life. Fedhealth. https://www.fedhealth.co.za/articles/dealing-with-stress-2/
- Johns Hopkins Medicine. (n.d.). 9 benefits of yoga. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/9-benefits-of-yoga
- Kim, K. H., et al. (2023). Ischemic heart disease. In National Center for Biotechnology Information. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK482382/
- Mayo Clinic. (2024). Coronary artery disease: Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
- Restivo, J. (2023). Heart-healthy foods: What to eat and what to avoid. Harvard Health Publishing. https://www.health.harvard.edu/heart-health/heart-healthy-foods-what-to-eat-and-what-to-avoid
- World Health Organization. (2020). Tobacco: Health benefits of smoking cessation. WHO. https://www.who.int/news-room/questions-and-answers/item/tobacco-health-benefits-of-smoking-cessation
- YouTube – NYU Langone Health. (2014, June 2). Cardiologist Dr. Nieca Goldberg on staying heart healthy [Video]. YouTube. https://www.youtube.com/watch?v=gFIlfsgEGj0
