Most chest pain does not come from the heart. Sudden pain that will not settle, spreads to your arm, jaw or back, or comes with sweating or breathlessness needs 999 straight away. Dr Navin Chandra, consultant cardiologist, assesses pain that comes and goes, or that still worries you. His clinics run at four hospitals across Ascot, Slough, Wexham and Windsor.
| Question | Answer |
|---|---|
| Common symptoms | Tightness, pressure or squeezing, pain on exertion that eases with rest, or sharp pain on breathing in |
| How it’s diagnosed | History and examination, an ECG, blood tests, then a CT coronary angiogram or a stress test if needed |
| Treatment options | Reassurance and self-care, angina medicines, a stent, or referral for bypass surgery |
| When to seek urgent help | Call 999 for the red flags below. See a GP for pain that comes and goes |
What Is Chest Pain, and When Is It the Heart?
Chest pain covers any pain, pressure, burning or discomfort in the chest. It has many causes, and the NHS notes that most are not related to the heart. Indigestion, strained muscles, chest infections and anxiety are all common.
When the heart is the cause, the problem is usually reduced blood flow to the heart muscle. Narrowed coronary arteries cause angina, a tight or heavy feeling brought on by effort. A sudden blockage causes a heart attack, which is an emergency.
- Stable angina: comes on with exertion, stress or cold and settles within minutes of rest.
- Unstable angina: a new or worsening pattern, or discomfort at rest. This needs urgent help.
- Heart attack: pain that does not go away, often with sweating or feeling sick.
- Pericarditis: a sharp, stabbing pain that worsens when you breathe deeply or lie down.
- Valve-related pain: a narrowed aortic valve can cause angina-like pain on effort. See TAVI for aortic stenosis.
The NHS page on chest pain gives a plain summary.
Heart and Non-Heart Causes and Risk Factors
Dr Chandra looks at heart and non-heart causes side by side.
- Coronary artery disease and angina: fatty build-up that narrows the heart’s own blood supply.
- Pericarditis or myocarditis: inflammation of the sac around the heart, or of the heart muscle.
- Aortic valve disease: a stiff, narrowed valve that makes the heart work harder.
- Reflux (GORD) or indigestion: burning after meals, often with a bitter taste.
- Chest wall strain: a sore muscle after injury or exercise, eased by rest.
- Anxiety or panic: sharp pain with a racing heartbeat, sweating or feeling dizzy.
- Chest infection or pleurisy: pain on breathing in, a cough with coloured mucus, and a temperature.
- Shingles: tingling skin, then a rash that turns into blisters.
Age makes a heart cause more likely, and so do the risk factors for coronary heart disease. These include smoking, obesity, raised blood pressure, diabetes and raised cholesterol. Close relatives with heart attacks or angina before the age of 60 also add to it.
Symptoms That Point to the Heart
Heart-related discomfort tends to share some features. It often feels like tightness, pressure or squeezing rather than a sharp stab.
- A heavy or squeezing feeling across the front of the chest
- Discomfort reaching the left arm, the neck or the jaw
- Shortness of breath alongside the discomfort
- Symptoms brought on by walking uphill, stress or cold weather
Some symptoms need emergency help, not a clinic appointment. This table shows where to go.
| Red-flag symptom | Go to |
|---|---|
| Sudden pain, pressure or a burning feeling in the chest that does not go away | Call 999 |
| Pain moving into either arm, or into your neck, jaw, stomach or back | Call 999 |
| Discomfort with sweating, feeling sick, light-headed or short of breath | Call 999 |
| Known angina that does not stop after rest or your angina medicine | Call 999 |
| Pain that comes and goes, or passed quickly but still worries you | See a GP, or call NHS 111 out of hours |
Nobody with these signs should drive themselves to A&E. Call 999 and wait where you are.
Anxiety, Reflux or the Heart: Why Each Feels Different
The setting of the pain often gives a clue. Reflux usually starts after eating and may bring up sour fluid. A strained muscle hurts more when you press on it or twist.
Anxiety can cause real, sharp pain, with a fast heartbeat and sweating. It deserves attention in its own right. Even so, Dr Chandra checks for a heart cause first when the pattern is not clear.
NICE describes three features of angina. The discomfort is tight and sits in the front of the chest, neck, shoulders, jaw or arms. It comes on with effort. It eases with rest within about 5 minutes. Pain with all three features is typical angina, and pain with two is atypical.
When to See a Specialist About Chest Pain
A cardiology opinion is worth booking in these situations.
- Discomfort on exertion that settles when you rest
- A new pattern, or angina that is happening more often or lasting longer
- Risk factors such as smoking, diabetes or a family history of early heart disease
- An abnormal ECG or blood test found by your GP
- Known heart disease with new or changing symptoms
You can book with a GP referral, through your insurer, or as a self-pay patient.
How the Cause Is Diagnosed: From ECG to CT Coronary Angiography
Your first consultation lasts up to 30 minutes. Dr Chandra takes a careful history of the pain, asks about risk factors and examines you.
- ECG: a resting tracing of the heart’s electrical activity. A normal result does not rule out angina, so NICE advises further tests when doubt remains.
- Longer ECG recording: a portable monitor worn over 24 hours or more, if symptoms come and go.
- Blood tests: these look for problems that can worsen angina, such as anaemia.
- CT coronary angiography: NICE recommends this scan first when the history suggests typical or atypical angina. It shows narrowing in the arteries.
- Functional tests: a stress echo or exercise test shows how the heart copes with effort. NICE uses these when coronary disease is already known.
- Coronary angiogram: a catheter test, used when a treatable narrowing is likely.
Dr Chandra arranges and reviews these tests and explains each result. More detail on each scan is on the cardiac imaging page.
Chest Pain Treatment Options After a Diagnosis
Treatment follows the test results.
Reassurance and Self-Care
A healthy heart result is useful news in itself. Reflux, muscle strain or anxiety can then be treated by your GP.
Medicines for Angina
One or two medicines reduce angina attacks. Others protect against a future heart attack or stroke. A fast-acting medicine is also prescribed for attacks.
Lifestyle and Cardiac Rehabilitation
Stopping smoking, eating well and staying active all protect the heart. Dr Chandra can advise on a rehabilitation programme.
A Stent
If a narrowing still causes symptoms on medicines, a balloon and stent may open it. Read about percutaneous coronary intervention for how this works.
Referral for Bypass Surgery
When several arteries are narrowed, bypass surgery may be the better choice. In that case Dr Chandra arranges a referral to a cardiac surgeon.
Living With Angina and Lowering Future Risk
Angina raises your risk of a heart attack or stroke, so treatment and healthy habits matter. With treatment, symptoms often improve and may stop. Most people carry on with work, exercise and sex once angina is well controlled.
- Avoid known triggers, such as stress, cold weather or large meals.
- Keep your angina medicine with you, and use it as your doctor advised.
- Stop smoking, keep to a healthy weight and stay as active as your symptoms allow.
- Keep alcohol to 14 units a week or less.
Why See Dr Chandra About Chest Pain?
Dr Navin Chandra is a consultant cardiologist at Frimley Health NHS Foundation Trust. He is also an honorary consultant at Royal Brompton and Harefield, where he trained in interventional cardiology.
That training means the doctor who assesses your pain can also perform an angiogram or stent if one is needed. Complex cases go to the Heart Team, and you see the same consultant throughout. Read more about Dr Navin Chandra.
Where Dr Chandra Sees Patients in Berkshire and Buckinghamshire
| Hospital | Address |
|---|---|
| The Parkside Suite, Heatherwood Hospital | Brook Ave, Ascot SL5 7GB |
| The Parkside Suite, Wexham Park Hospital | Wexham, Slough, Berkshire SL2 4HL |
| BMI Princess Margaret Hospital | Osborne Road, Windsor, Berkshire SL4 3SJ |
| Spire Thames Valley Hospital | Wexham Street, Wexham, Buckinghamshire SL3 6NH |
Ask the practice which days each hospital runs a clinic. Call 020 7099 9685 or email enquiries@navinchandra.co.uk with any questions. If you feel unwell out of hours, NHS 111 can help, and 999 is for emergencies.
Chest Pain Consultation Fees and Insurance
2026 fees are confirmed when you book. Tests such as a CT scan or stress echo are priced separately.
- Insured: ask your insurer about cover and pre-authorisation before you attend. The practice works with Bupa, AXA Health, Aviva, Cigna, WPA, Healix and Vitality, among others.
- Self-pay: you can book directly, and test costs are explained before they go ahead.
FAQs About Chest Pain
How can I tell if my pain is coming from my heart?
Heart pain is usually a tight or heavy feeling brought on by effort that eases with rest. Pain after meals, on pressing the chest or on breathing in is less likely to be the heart. Only tests can confirm it.
Can angina lead to a heart attack?
Angina is a warning that the heart is short of blood. People with angina have a higher chance of a heart attack. Treatment and lifestyle changes lower that risk. Angina that is getting worse needs urgent advice.
Does angina show up on an ECG?
Not always. A resting ECG is often normal between attacks. NICE says a normal ECG does not rule out angina, so a CT coronary angiogram or stress test may follow.
Can stress or anxiety cause real chest pain?
Yes. Anxiety and panic can cause sharp pain, a racing heartbeat and sweating. Dr Chandra still makes sure the heart is healthy before putting the pain down to anxiety.
Should I go to A&E or book a cardiologist?
Call 999 for sudden pain that will not settle, pain that spreads, or pain with sweating or breathlessness. Pain that comes and goes is a reason to see a GP or book a consultation.
Is pain on the left side of the chest more serious?
Not on its own. The NHS treats spreading pain, into an arm, the jaw, the stomach or the back, as a warning sign. Those red flags matter more than which side hurts.
What happens if angina is left untreated?
Untreated angina carries a higher risk of heart attack and stroke. Symptoms may also become more frequent and limit what you can do. Treatment aims to ease symptoms and lower that risk.
Book a Chest Pain Consultation with Dr Navin Chandra
- Phone: 020 7099 9685
- Email: enquiries@navinchandra.co.uk
- Online: the booking form, for an in-person or virtual visit
If the pain is happening now and matches the red flags above, call 999. NHS 111 gives urgent advice when it is not an emergency.
Related symptoms are covered on the breathlessness and palpitations pages. You can also view every symptom Dr Chandra assesses, or use the contact form.