Chest pain refers to pain or discomfort in the chest area, which includes the heart, lungs, esophagus, ribs, sternum (breastbone), muscles, tendons and nerves. It may begin in the chest area or be referred pain from other areas.

Chest pain is a symptom of an underlying condition. Although many people associate chest pain with heart conditions, many noncardiac disorders can also trigger it. The underlying condition may be life-threatening (e.g., heart attack, pulmonary embolism), but most times it is not (e.g., heartburn, muscle strain, costochondritis, transitory benign chest wall pain, panic attack).

To ensure proper treatment, people experiencing any form of chest pain are encouraged to contact their physician. Patients should contact their physician immediately when chest pain lasts longer than three to five days, and when it is accompanied by fever or a cough that produces yellow-green phlegm. Patients should seek emergency medical treatment when chest pain is severe or is accompanied by nausea, dizziness, sweating, a racing heart or shortness of breath. A sudden sensation of crushing, squeezing, tightening or pressure in the chest, or pain that radiates to the jaw, neck, arm or shoulder blade, is also a cause for serious concern.

To determine the cause of chest pain, a physician may order a number of tests including blood tests, electrocardiograms and imaging studies such as x-rays or MRI. Treatment for chest pain depends on its cause. Though some causes require only minor treatment (e.g., antacids, NSAIDs), more serious conditions may require surgery such as angioplasty or coronary bypass. Some conditions may even resolve with no medical treatment. 

Chest pain is pain or discomfort that occurs anywhere along the front of the body between the neck and upper abdomen. It may be caused by any organ or tissue located in the chest, including the heart, lungs, esophagus, ribs, sternum (breastbone), muscles, tendons, nerves and blood vessels.

Chest pain is a common complaint. More than 5 percent of emergency room visits are due to chest pain, the U.S. Centers for Disease Control and Prevention (CDC) has estimated. Many people seek emergency treatment for their chest pain because they associate the symptom with heart attack and other cardiac disorders. Although chest pain may be due to cardiac problems, most cases are due to noncardiac causes.

In addition to problems with organs and tissues in the chest, chest pain may be caused by conditions affecting the digestive tract. A number of psychological disorders can also trigger chest pain, such as anxiety and panic disorders.

Chest pain can be caused by something as simple as heartburn or as severe as a life-threatening heart attack. As a result, all forms of chest pain should be reported to a physician.

Patients should seek immediate emergency medical treatment when:

• There is a sudden sensation of crushing, squeezing, tightening or pressure in the chest
  
  
• The pain radiates to the jaw, neck, arm or between the shoulder blades
  
  
• The pain is more intense, triggered by less strenuous activity or longer lasting than usual (in patients diagnosed with angina)
  
  
• Symptoms occur during periods of rest (in patients diagnosed with angina)
  
  
• The pain is accompanied by nausea, dizziness, sweating, fatigue, a racing heart or shortness of breath

In other cases, patients should contact their physician when pain:

• Is accompanied by fever
  
  
• Is accompanied by a cough that produces yellow-green phlegm
  
  
• Lasts longer than three to five day

Chest pain may be caused by a variety of heart (cardiac) and noncardiac conditions.

Among the most common noncardiac causes of chest pain are:

• Indigestion (dyspepsia). Discomfort in the upper abdomen. It is sometimes accompanied by a feeling of fullness, belching, bloating and nausea.
  
  
• Heartburn. A burning sensation in the chest or throat caused by the backup (reflux) of stomach acid into the esophagus. Chest pain related to heartburn typically follows a meal and lasts anywhere from a few minutes to a few hours. The pain may occur more often when the patient bends over or lies down.
  
  
• Gastroesophageal reflux disease (GERD). A chronic condition in which the valve (sphincter) that closes the esophagus from the stomach weakens or relaxes and lets acid and partly digested food move up into the throat.  The acid can damage the esophagus, which lacks the protective mucus of the stomach. Heartburn is a common symptom of GERD.
  
  
• Strain or inflammation of the muscles and tendons. Muscle-related chest pain may occur as the result of physical activity involving the chest muscles, injury or coughing. Persistent muscle-related chest pain may occur in people with chronic pain syndromes such as fibromyalgia, myofascial pain syndrome or arthritis. Chest pain related to sore muscles often occurs when a person twists from side to side or raises the arms. Uncommon causes of musculoskeletal chest pain include rib-tip syndrome, sternalis syndrome, sternoclavicular hyperostosis and xiphoidalgia.
  
  
• Asthma. A condition in which inflammation of the airways restricts airflow into and out of the lungs.
  
  
• Psychological factors. Anxiety, hyperventilation (rapid or deep breathing often triggered by anxiety), panic, stress and emotional upsets may cause feelings of pressure in the chest.

Cardiac causes of chest pain include:

• Angina.  This is recurrent chest pain caused by inadequate blood flow through the heart. It may cause a feeling of tightness or pressure in the chest. Angina is usually triggered by physical or emotional stress, and often disappears within minutes after the stressful activity is stopped. Angina is generally associated with coronary artery disease (CAD).
  
  
• Heart attack. Also known as a myocardial infarction, a heart attack occurs when an area of heart muscle dies or is permanently damaged as the result of an inadequate supply of oxygen to that area. This can trigger a feeling of pressure, fullness, squeezing or a crushing pain lasting longer than a few minutes. The pain may radiate to other areas of the body including the back, jaw, neck, shoulders and arms. In some cases, chest pain related to heart attack is accompanied by shortness of breath, sweating, dizziness and nausea.
  
  
• Coronary artery spasm. Also known as Prinzmetal’s angina or variant angina, this is a condition in which the muscles in the wall of an artery in the heart temporarily and abruptly contract. As a result, the artery is constricted and blood flow is temporarily slowed. Chest pain related to this condition may occur during periods of activity or rest.
  
  
• Pericarditis. Inflammation of the pericardium, the sac-like covering of the heart. This condition is often characterized by sharp, piercing and centralized chest pain. Patients may also have a fever. Usually triggered by a viral infection, pericarditis can also result from conditions including Lyme disease and lupus.
  
  
• Aortic dissection. A condition in which there is bleeding into and along the wall of the aorta (the main artery leading from the heart). It may be associated with a sudden, severe, sharp, stabbing, tearing, or ripping sensation in the chest. The pain may also radiate to other areas including the shoulders, neck, arms, jaw, abdomen or hips. The condition usually results from traumatic injury to the chest or uncontrolled high blood pressure.
  
  
• Aortic aneurysm. Widening or bulging of part of the aorta. Aneurysms often have no symptoms, but some patients may experience abdominal, back or chest pain. A ruptured aortic aneurysm is a life-threatening emergency that often causes sudden, severe pain.
  
  
• Cardiac syndrome X. A condition in which patients experience chest pain similar to angina without actually meeting the diagnostic criteria for CAD.
  
  
• Endothelial dysfunction. Endothelium is the inner lining of cells in the blood vessels. Endothelial dysfunction is characterized by the failure of the endothelial cells to function normally. As a result, the cells lose their ability to control the dilation of the blood vessels.
  
  
• Myocarditis. This is an inflammation of the heart muscle. The chest pain associated with this condition may mimic the pain caused by a heart attack.
  
  
• Cardiomyopathy (enlarged heart). Conditions including chronic diseases, alcoholism, heart attacks and viral disease can cause the heart to become abnormally big, thick and stiff. A variation known as Takotsubo or stress cardiomyopathy, sometimes called broken heart syndrome, is often preceded by emotional or physical distress.
  
  
• Mitral valve prolapse. The mitral valve controls blood flow between the heart’s left atrium and left ventricle. In patients with mitral valve prolapse, one of the flaps moves back into the atrium when the heart beats. As a result, blood can flow from the ventricle back into the atrium. This condition may cause intermittent (coming and going) chest pain.
  
  
• Aortic stenosis. A condition in which the heart’s aortic valve is narrowed or obstructed. This prevents it from opening correctly. As a result, blood flow from the left ventricle to the aorta is blocked. The chest pain associated with this condition may be described as a crushing or squeezing sensation, pressure or tightness. The pain may increase with exercise and be relieved with rest.
  
  
• Cardiac tamponade. A condition in which fluid accumulates in the pericardium. Causes of cardiac tamponade include pericarditis, trauma, heart attack and complications of kidney disease.

Additional lung-related (pulmonary) causes of chest pain include:

• Pneumonia. A condition in which the lungs are inflamed as the result of an infection.
  
  
• Bronchitis. A condition in which the lining of the airways that connect the trachea to the lungs (bronchial tubes) becomes inflamed. Patients with this condition may experience chest pain or feelings of soreness or constriction in the chest.
  
  
• Pulmonary embolism. A condition in which an artery in the lung becomes blocked (usually by one or more blood clots). Chest pain associated with this condition may appear under the breastbone (sternum) or on one side of the chest. The pain may feel sharp or stabbing, aching or dull, or like a burning or heavy sensation. The pain may intensify with deep breathing, coughing, eating or bending over.
  
  
• Pneumothorax. A condition in which air or gas collects in the space surrounding the lungs (plural space). The sudden sharp chest pain caused by this condition may intensify with deep breathing or coughing.
  
  
• Pleurisy. A condition in which the lining of the lungs (the pleura) is inflamed. It often causes localized pain on the chest wall. Patients with this condition may experience pain with each breath, and pain that intensifies with deep breathing and coughing.
  
  
• Pleural effusion. A condition in which the fluid between the layers of the membrane that lines the lungs and chest cavity accumulates. Patients with this condition may experience sharp chest pain that intensifies with deep breathing and coughing.
  
  
• Histoplasmosis. Caused by Histoplasma capsulatum, histoplasmosis is a fungal infection that primarily affects the lungs. Patients with this condition may experience chest pain, especially when inhaling.

Additional causes of chest pain related to the digestive system include:

• Gastric ulcer. Also known as a stomach ulcer, a gastric ulcer is an erosion in the lining of the stomach. Pain related to an ulcer may intensify when the stomach is empty.
  
  
• Gallbladder disease. A condition in which the gallbladder is inflamed (cholecystitis), infected or obstructed. Gallbladder disease can cause abdominal pain that radiates to the chest. Pain associated with the gallbladder often intensifies after a meal, particularly one containing fatty food.
  
  
• Gallstones. Also known as cholelithiasis, gallstones are stone-like masses. They are formed when liquid stored in the gallbladder (bile) hardens. People with gallstones may experience abdominal pain that radiates to the chest.

Other causes of chest pain include:

• Injured ribs or sternum. Bruises or fractures of the ribs or sternum can cause chest pain. Chest pain due to such trauma is typically localized and sharp. Motor vehicle accidents or other sources of severe trauma to chest can cause a condition known as flail chest, in which multiple rib fractures alter the chest wall.
  

A sternal or rib fracture may also result from osteoporosis, a bone-thinning disease most common in women after menopause, or stem from bone weakness caused by certain forms of cancer, such as multiple myeloma.

• Costochondritis. A condition in which the cartilage connecting the sternum and ribs becomes inflamed. Chest pain associated with this condition may occur suddenly and be intense. Patients with costochondritis will typically experience chest pain when the sternum or the ribs near the sternum are pushed on.
  
  
• Transitory benign chest wall pain. Brief and often sharp pain that is sporadic and not harmful. It occurs more often in children and young adults.
  
  
• Sarcoidosis. A condition in which inflammatory lumps form in organs, most often the lungs. Sometimes sarcoidosis affects the heart, which can also cause chest pain.
  
  
• Pinched nerve. Nerve damage caused by compression, constriction or stretching of a nerve. A pinched nerve can trigger localized and sharp chest pain. Even a herniated disc in the spine can radiate pain to the chest.
  
  
• Esophageal spasm. A condition in which muscles in the esophagus contract irregularly. The condition can begin suddenly with no known cause and may resolve on its own. Pain can range from mild to excruciating.
  
  
• Esophagitis. Inflammation of the esophagus. 
  
  
• Achalasia. A disorder of the esophagus in which the valve in the lower esophagus does not open properly to allow food to enter the stomach. As a result, food backs up into the esophagus, causing gastric pain. Chest pain associated with this condition may increase after eating or radiate to the back, neck and arms.
  
  
• Barrett’s esophagus. A chronic condition, associated with GERD, in which the lining of the esophagus is replaced by tissue similar to intestinal tissue.
  
  
• Nutcracker esophagus. A condition in which contractions of the esophagus are abnormally strong during swallowing. It is often caused by GERD.
  
  
• Shingles (herpes zoster) Infection of the nerves with the varicella-zoster virus. Shingles can cause a painful, blistering rash on the back and chest wall. Chest pain associated with this condition may be described as sharp and burning pain. It may develop before the blisters appear.
  
  
• Hiatal hernia. A condition in which part of the stomach protrudes upward into the chest through a gap in the diaphragm.
  
  
• Pancreatitis. A condition in which the pancreas is inflamed or infected. Abdominal pain associated with pancreatitis can radiate to the chest.
  
  
• Sickle cell anemia. An inherited condition in which red blood cells, which are usually disc-shaped, become crescent shaped. Chest pain is a common symptom.
  
  
• Cancer. Cancer involving the chest (e.g., lung cancer), or cancer that has spread to the chest from another part of the body can cause chest pain.

Physicians will consider a number of factors when attempting to determine the cause of a patient’s chest pain. Because certain cardiac causes of chest pain are life-threatening (e.g., heart attack) and require immediate treatment, physicians will often focus on ruling out heart disorders first. Physicians may also test for life-threatening lung conditions, including pulmonary embolism, aortic dissection and pneumothorax.

An evaluation for chest pain may begin with a physician taking the patient’s medical history and performing a physical examination. These steps can provide a physician with important clues and help them determine the cause of the chest pain.

While collecting a patient’s medical history, physicians may ask questions aimed at determining if the patient has cardiac risk factors. Patients may be asked to complete a pain assessment or be asked a number of questions about pain, including:

• Where is the pain located? Does the location of the pain change?
  
  
• Does the pain radiate to other areas of the body (e.g., neck, back, jaw, shoulder, arm)?
  
  
• What does the pain feel like (e.g., severe, tearing or ripping, sharp, stabbing, burning, constricting, pressure-like, aching, dull, heavy)?
  
  
•  Does the pain occur suddenly or gradually?
  
  
• Does the pain appear at the same time each day?
  
  
• How long does the pain last?
  
  
• Is the pain getting worse?
  
  
• Are there any activities that cause the pain to intensify (e.g., deep breathing, coughing, eating, bending over)?
  
  
• Does pain occurring during exercise improve with rest? If so, is the pain completely relieved or just slightly improved?
  
  
• Are there any factors that relieve the pain (e.g., nitroglycerin medication, drinking milk, taking antacids, belching)?
  
  
• Do any other symptoms accompany the pain?

The evaluation will include monitoring of the patient’s vital signs, including pulse rate, blood pressure, rate of breathing and temperature. During the physical examination a physician will focus on examining the chest wall, lungs and heart. A cardiac examination may be performed. This may include auscultation (listening to sounds of the organs with a stethoscope) to look for symmetry of breathing sounds, wheezing or crackling. Physicians may also perform palpitation (feeling) of the chest wall. This will enable them to locate areas of tenderness. An examination of the abdomen may also be performed.

A number of tests are usually required to determine the cause of chest pain. This allows physicians to eliminate a number of causes and close in on an exact source. Information provided in the patient’s medical history and factors revealed in the physical examination are used to determine which tests to order. These may include:

• Blood tests. These tests determine the amount of any given substance in a blood sample. Increased levels of certain enzymes in the blood may indicate heart damage, such as that caused by a heart attack. Blood tests ordered during an evaluation for chest pain may include LDH (lactate dehydrogenase) tests, LDH isoenzymes tests, CPK (creatine phosphokinase) tests, CPK isoenzymes tests, troponin tests, complete blood counts and blood differential tests.
  
  
• Electrocardiogram (EKG or ECG). This test records the electrical activity of the heart through electrodes attached to the skin. The activity is recorded as waves displayed on a monitor or a moving strip of paper. ECG can reveal the presence of heart damage because injured heart muscle does not conduct electrical impulses normally. ECGs can help physicians diagnose a number of heart disorders, including heart attack that has occurred or is in progress.
  
  
• Exercise stress test. Also known as an exercise EKG, an exercise stress test measures how the heart and blood vessels respond to physical exertion. During the test, patients hooked up to an EKG may be asked to walk on a treadmill or pedal a stationary bicycle. In some cases the patient receives a drug intravenously to stimulate the heart. This test, which is sometimes used in combination with echocardiography and radionuclide imaging (a procedure in which radioactive material is introduced into the body for the purpose of imaging), can reveal if chest pain is related to the heart. It is one of the most common tests performed to diagnose coronary artery disease.
  
  
• Upper endoscopy. A camera mounted on a flexible tube (endoscope) is inserted through the mouth and down the throat. This allows the physician to inspect the esophagus, stomach and the upper portion of the small intestine. This test may reveal gastroesophageal (involving the stomach and esophagus) disorders that can cause chest pain. A biopsy may be performed so a tissue sample from the stomach can be analyzed to rule out conditions such as stomach cancer. Endoscopy is typically performed in a hospital with the patient under anesthesia.
  
  
• Cardiac catheterization. A catheter (a thin flexible tube) is inserted through a blood vessel, usually in the groin, and passed into the right or left side of the heart. This enables physicians to obtain diagnostic information about the heart and its blood vessels, including pressure and blood flow in the heart’s chambers.

Possible imaging studies include:

• Chest x-rays. An x-ray is a painless test in which an image is created of part of the body. It uses low doses of electromagnetic radiation that are reflected on film or fluorescent screens. Chest x-rays enable physicians to examine the condition of the heart, lungs and major blood vessels.
  
  
• Electron beam computerized tomography (EBCT). This advanced, fast form of CAT scan may be used to scan the arteries for signs of calcium deposits. The presence of calcium often suggests that fatty deposits may be accumulating and blocking the arteries supplying blood to the heart.
  
  
• MRI (magnetic resonance imaging). MRIs use a powerful magnetic field to create images of structure and organs within the body allowing a computer to produce clear cross-sectional or three-dimensional images. These tests may be ordered to determine if a patient’s chest pain is related to a cardiac problem.
  
  

  

• Echocardiogram. This form of ultrasound uses sound waves to create a moving image of the heart. These tests are helpful in an evaluation of chest pain because they can reveal heart problems.
  
  
• Lung scan. A form of radionuclide imaging, a lung scan involves injecting a small amount of radioactive gallium into a patient’s vein. At a later time, a scanner (gamma camera) is moved over the patient’s body to detect the gamma rays emitted by the gallium. The information picked up by the camera is then transmitted to a computer which displays an image on its screen.
  
  
• Angiogram. An x-ray machine is used to provide a clear picture while contrast medium (dye) is injected into one of the patient’s arteries. The arteries become visible to an x-ray machine as they fill up with the dye. As a result, physicians are able to identify individual arteries that may be narrowed or blocked.

Scientists report that a new radioactive tracer, iodofiltic acid I 123, can be used with a nuclear imaging technique called a SPECT scan to distinguish cardiac causes from noncardiac causes up to 30 hours after a patient experiences chest pain. Further research will be needed before this test may become a standard diagnostic tool.

Relief options for chest pain depend on the cause. Some causes require serious medical treatment such as surgery, whereas others are less serious and may require medication. Some causes may even resolve on their own.

Oxygen is given to patients who come in with chest pain, to increase the oxygen supply to heart. In addition, a variety of medications may be prescribed to treat chest pain. Cardiac chest pain may be treated with drugs including:

• Aspirin. This nonsteroidal anti-inflammatory drug (NSAID) reduces blood clotting. As a result, blood flow through narrowed heart arteries may be maintained. Aspirin may be recommended to relieve angina or prevent second heart attacks.
  
  
• Morphine. This opioid may be used to ease severe chest pain, usually associated with a cardiac cause.
  
  
• Nitroglycerin. Typically prescribed to prevent angina, this drug temporarily opens narrowed blood vessels. As a result, blood flow to and from the heart is improved.
  
  
• Beta blockers. These drugs reduce the workload of the heart and lower blood pressure. They may be used to treat patients with angina or to prevent additional heart attacks.
  
  
• Angiotensin-converting enzyme inhibitors. Also known as ACE inhibitors, these drugs widen blood vessels and lower blood pressure by blocking production of angiotensin II, a substance that causes blood vessels to tighten and regulates blood pressure. They may be used after a heart attack to increase survival rates.
  
  
• Angiotensin II receptor blockers (ARBs). These drugs widen blood vessels by preventing angiotensin II from entering angiotensin II receptors.
  
  
• Calcium channel blockers. These drugs block the movement of calcium ions into heart cells and blood vessels. This increases the supply of oxygen-rich blood to the heart, lowers blood pressure and reduces the heart’s workload. They may be used to treat angina.
  
  
• Clot-busting drugs. These drugs are used to dissolve or break up a blood clot. They may be used to lessen long-term damage from a heart attack.

In addition to medication, angina and heart attack may be treated with a number of other methods, including:

• Angioplasty. A procedure in which a balloon is used to widen narrowed or blocked blood vessels of the heart (coronary arteries). This improves blood flow to the heart.
  
  
• Coronary bypass surgery. This procedure is used to create new passages for blood to travel to the heart muscle. Arteries or veins taken from other areas of the body are used to reroute, or bypass, blood around a clogged artery. This improves blood flow to the heart.
  
  
• Enhanced external counterpulsation (EECP). Performed in a series of sessions lasting over several weeks, this method involves inflating pressure cuffs that are placed on the legs. This causes blood vessels in the legs to compress, forcing blood back to the heart.
  
  
• Stenting. A procedure in which a wire mesh tube is inserted through a catheter and placed in an artery to hold it open. It is usually performed immediately after angioplasty.

In addition to heart attacks, other life-threatening conditions will require emergency medical treatment. Patients experiencing pulmonary embolism may require treatment with emergency anticoagulants. Aortic dissection, another emergency, may require surgery. Patients diagnosed with cancer will be referred to an oncologist for the appropriate treatment.

In most cases, chest pain is not related to a life-threatening heart or lung condition. Pain management options for less serious causes include:

• Heartburn. This condition may be relieved with over-the-counter or prescription-strength stomach acid blocker or antacid. Chronic heartburn may require dietary modifications and surgery.
  
  
• Gastroesophageal reflux disease (GERD). Many prescription medications are available, including acid reducers, promotility agents, prokinetic agents, foam barriers and histamine H2 receptor blockers. Avoiding certain foods, such as citrus or tomato products, helps some individuals. Several surgical options are available if noninvasive measures fail.
  
  
• Anxiety. Patients suffering from anxiety may benefit from prescription anti-anxiety medications, relaxation techniques and psychological counseling.
  
  
• Pleurisy. Over-the-counter pain relievers (analgesics) may be recommended to relieve chest pain caused by pleurisy.
  
  
• Costochondritis. Patients with this condition may relieve chest pain with rest, heat (thermotherapy), NSAIDs) (e.g., ibuprofen) and corticosteroid injection into the joint for severe pain.
  
  
• Shingles. This condition may be relieved with antiviral medication. Analgesics and antihistamines may also be prescribed to control pain and itching.
  
  
• Gallbladder or pancreas disorders. Surgery may be recommended to relieve chest pain caused by an inflamed gallbladder or pancreas.
  
  
• Muscle strain. Muscle-related chest pain may be relieved with acetaminophen, ibuprofen, ice (cryotherapy), heat and rest.
  
  
• Back conditions. Treatment options may include physical therapy, medications, corticosteroid injections and back surgery.

Patients with chronic conditions, such as asthma, can benefit from taking their medications exactly as prescribed by their physicians. This may prevent flare-ups of the condition and related chest pain.

Treatments that may be recommended for chronic chest pain include cognitive behavioral therapy and biofeedback.  

Many causes of chest pain cannot be prevented. However, there are a few steps people can take to reduce their risk. These include:

• Achieving and maintaining a healthy body weight
  
  
• Controlling high blood pressure
  
  
• Managing cholesterol levels
  
  
• Controlling diabetes

• Avoiding tobacco use and second-hand smoke
  
  
• Eating a diet low in saturated and hydrogenated fats and low in cholesterol
  
  
• Eating a diet high in fiber, fruits and vegetables
  
  
• Avoiding any foods that cause gastroesophageal discomfort, which may include fried foods, fatty foods, citrus or tomatoes
  
  
• Exercising three or more hours a week
  
  
• Reducing stress

Patients who make these healthy lifestyle choices can reduce their risk of chest pain by preventing heart disease.

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about chest pain:

1. What might be causing my chest pain?
   
   
2. Can I tell if my chest pain is due to heart trouble or lung problems or to a less serious condition?
   
   
3. When should I treat chest pain as an emergency?
   
   
4. What tests may be used to determine the cause of my chest pain?
   
   
5. What do these tests involve?
   
   
6. If an upper endoscopy is needed, can it be done in your office, or do I have to have it in a hospital under general anesthesia?
   
   
7. How do I know if my chest pain is serious?
   
   
8. Can medications help my chest pain?
   
   
9. What other types of treatment can reduce my chest pain?
   
   
10. Are there certain exercises and activities I should do or avoid?
    
    
11. How can I prevent chest pain?