Chest pain causes

Chest pain has many causes — reflux, muscle strain, anxiety, or cardiac. Sudden severe pain or shortness of breath is an emergency; otherwise a provider can triage online.

Also called: what causes chest pain · heart attack vs anxiety · chest tightness

Medically reviewed by Dr. Ikechukwu Ogbu, MD
MD · Board-Certified, Internal Medicine · Last reviewed

Call 911 immediately if you have:

  • Crushing pressure, tightness, or squeezing in the chest lasting more than a few minutes
  • Pain radiating to the arm, jaw, neck, or back
  • Shortness of breath, sweating, nausea, or lightheadedness with chest pain
  • Sudden severe chest pain with a tearing or ripping quality
  • Chest pain with fainting or a fast/irregular heartbeat

What chest pain causes could be

The most common causes a clinician considers. This isn't a diagnosis — it's the differential a provider works through with you.

GERD / acid reflux

GERD / acid reflux is one of the more common causes of chest pain causes. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Anxiety

Anxiety is one of the more common causes of chest pain causes. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Panic disorder

Panic disorder is one of the more common causes of chest pain causes. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Typical workup

What a clinician usually orders or asks about when someone presents with chest pain causes.

  • First priority: rule out cardiac causes — EKG and troponin in the ER when concerning
  • For non-cardiac evaluation: reflux trial, musculoskeletal exam, anxiety screening
  • Stress test or CT coronary angiography when risk factors warrant further workup

When to see a clinician

  • Symptoms have lasted more than a few days without improving, or keep coming back
  • You're not sure if this needs antibiotics, prescription treatment, or watchful waiting
  • You have a chronic condition (diabetes, heart disease, immunocompromised) that raises the stakes
  • You want a same-day plan without a trip to urgent care

Common questions