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ASK DR ZOE

When chest pain is a sign you need emergency help – and other worrying diagnoses

Scroll down to find out what conditions can cause chest pain
a woman in an orange shirt is holding a stethoscope in front of a blue curtain

EXPERT advice from Dr Zoe Williams, our resident specialist and NHS GP.

Q: I KEEP getting pains across my chest, sometimes at night when I have eaten bread.

Dr Zoe gives advice to a reader who is concerned about chest pain
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Dr Zoe gives advice to a reader who is concerned about chest painCredit: Olivia West
When is chest pain a sign of something serious?
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When is chest pain a sign of something serious?Credit: Getty - Contributor

I also occasionally get tingling feelings.

A: With chest pain, the first thing we always consider is whether it could be a heart attack or angina.

These are most likely to come on with exertion, but can come on at rest or be triggered by eating a large meal.

It’s always important to seek urgent medical attention if it could be your heart.

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Other conditions that can cause chest pain are benign and treatable but in more serious cases, it could be a sign of oesophageal or stomach cancer.

There could be additional red flags, including loss of appetite, weight loss, fatigue or blood in the stool.

Gastro-oesophageal reflux disease is when stomach acid can reflux up into the oesophagus causing inflammation.

Symptoms include heartburn, pain when you swallow and ‘acid brash’, which is when you taste the acid in your mouth.

Occasionally there are no symptoms and over time it can cause ulcers, scarring or narrowing of the oesophagus leading to difficulty swallowing.

A hiatus hernia can cause chest symptoms when eating – this is when the top part of your stomach bulges through the diaphragm into the chest.

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It’s very common in people over the age of 50 and symptoms can usually be managed without surgery.

There are also a group of oesophageal motility disorders which cause the oesophagus to spasm, which can be painful, and sometimes gets confused for angina.

Once the cause is identified you can explore management options to help resolve these symptoms.

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