Signs and symptoms | Possible cause |
Pain can be dull, tight, heavy, squeezing Usually in centre of chest but can be in shoulders, arms, back, neck, jaw. May be
felt on right side Cool and sweaty, nauseous, short of breath Pain often occurs with exercise or exertion of any kind (walking, arguing) | Heart pain — medical consult Heart attack OR Angina — episodic chest pain |
Severe pain through to the back — may have neurological deficit. Older person with a history of hypertension —may be complicated by AMI | Aortic dissection — medical consult |
Sudden onset of unilateral pain Pain sharp, mostly on deep breathing May have fast or shallow breathing or short of breath May have a history of cough or trauma Reduced breath sounds or chest movement on one side More common in men 20-40 years, COPD | Pneumothorax — medical consult |
Fever, cough, shortness of breath Pain sharp and mostly on deep breathing Reduced breath sounds, abnormal sounds in lungs — especially on one side Comes on gradually over hours to days | Pneumonia/pleurisy |
Sudden sharp unilateral pain, mostly on deep breathing Shortness of breath Painful swollen leg, may cough up blood Consider if — cancer, leg in plaster, pregnant, postnatal, operation in past 2 months,
lot of time sitting or lying (eg older person, confined to bed) long distance car/plane
travel, previous blood clot | Pulmonary embolus (blood clot in lung) — medical consult |
Burning or sharp pain Abdominal tenderness, chest or shoulder discomfort Pain behind breastbone after eating or when lying down Often in people who drink alcohol, who are obese or pregnant Always exclude AMI — relief with antacid +/- local anaesthetic does not rule out ischemic heart disease/cardiac | Reflux Oesophageal spasm — medical consult Peptic ulcer |
History of injury Pain on moving shoulders or upper body and settles when still Local muscle tenderness | Muscle pain — medical consult |
| Tenderness to palpation of costochondral joints | Costochondritis — medical consult |