People suffer chest pain for a range of reasons. Any chest pain that lasts for more than 15 minutes should be considered as serious.

A heart attack – also known as a myocardial infarction (MI) or by the term coronary thrombosis – is one of the most serious heart conditions. A heart attack occurs when one of the main blood vessels that run around the outside of the heart to supply the heart muscle with blood is blocked. The severity of the attack depends on the location of the blockage: a small blood vessel will cause chest pain and other symptoms, but the patient should recover after medical treatment. Blockage of a major blood vessel can lead to the heart stopping (cardiac arrest) and the need for CPR.

Causes of chest pain
Causes of chest pain

An angina attack occurs where the patient has narrowed blood vessels around the heart. The pain of angina may occur during exercise or exertion, or when at rest, when an insufficient blood supply causes chest pain and distress. Most angina patients carry medication that will relax the muscular walls of the affected blood vessels, allowing more blood to flow through and relieve the pain. Angina may lead to a heart attack later and the patient should be treated as for a possible heart attack if a dose of their prescribed medication fails to relieve the pain within 15 minutes.

Symptoms and signs – Not all may be present

  • pain or an uncomfortable pressure in the middle of the chest that does not ease after 15 minutes of rest
  • the chest pain may:
    • radiate up the neck and into the jaw and teeth
    • radiate into the shoulder or down one or both arms
    • feel as if a crushing weight is resting on the patient’s chest
    • feel as if a steel band around the chest is being tightened
    • shortness of breath
    • pale or bluish skin
    • light-headedness or fainting
    • sweating
    • nausea
    • a feeling of great anxiety, weakness or fatigue
    • a request for any medication prescribed for angina pain
    • sudden collapse
Anginal pain is usually centred in the chest region
Anginal pain is usually centred in the chest region
The pain may spread to the neck and jaw ,and down one or both arms.
The pain may spread to the neck and jaw ,and down one or both arms.

How you can help

1.    Assist the patient to rest

  • Help the conscious patient to rest in the position of greatest comfort, generally in a half-sitting position with support for the back and head. 
  • If outdoors with no chair readily available, kneel behind the patient to provide support while completing an initial assessment. 

If the patient is unconscious or not responding, call for an ambulance. The patient may require CPR.

2.    Assess the patient

  • Assess the patient’s conscious state every few minutes and be ready to start CPR if collapse occurs. 
  • Assist the patient to take any medication prescribed for chest pain.

Unless the pain eases totally with the prescribed medication – call for an ambulance.

When in doubt, always send for an ambulance in case collapse suddenly occurs.

  • Avoid giving any food, fluids or stimulants such as alcohol, cigarettes, tea or coffee.

3.    Try to keep the patient calm

  • Try to keep the patient calm with constant reassurance because any stress or activity could cause complications or even collapse.
  • Loosen any tight clothing at the neck and waist to assist breathing.

Never transport a patient with chest pain in a car. Additional exertion could cause the heart to suffer more damage. Deterioration of the patient in a vehicle is very difficult to manage.

Assist the patient to rest

Assist the patient to rest


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