Is Chest Pain a Heart Attack? One Minute to Decide If You Need Emergency Care

When chest pain strikes, fear instantly overwhelms you.

Hand clutching your chest, pain compresses your sternum, like a giant stone pressing on it. Cold sweat breaks out, breathing becomes rapid. You want to speak but your voice fails.

Is this a heart attack? Should you call 120? Go to hospital or observe a bit? In that moment, these questions could determine life or death.

Myocardial infarction (heart attack) is currently one of the deadliest diseases in China. Even more concerning is that many heart attack patients miss optimal treatment time because they don't recognize symptoms, hesitating whether to seek medical care. Myocardial cell death is irreversible—every minute of delay means more myocardial cells die, survival chances decrease.

Heart attack chest pain has fairly typical characteristics—remembering these features could save your life in critical moments:

Location: Behind sternum or precordial area—the chest area covered by both palms. Pain may radiate to left shoulder, left arm (medial to little finger), neck, jaw (toothache sensation), back. Many people seek dental or orthopedic care for tooth pain or shoulder pain, never imagining it's a heart issue.

Quality: Crushing, tightening, burning pain. Many patients describe it as "like a stone pressing on chest," "like being constricted by rope," "chest is on fire." Not sharp or knife-like.

Severity: Moderate to severe, often the most severe pain the patient has ever experienced. Pain score often exceeds 7/10.

Duration: Angina (cardiac ischemia without cell death) typically lasts 5-15 minutes, relieved by rest or nitroglycerin. Heart attack pain persists over 15-20 minutes, won't relieve with rest, nitroglycerine has poor or no effect.

Triggers: Angina often has clear triggers—exertion, emotional excitement, cold, after meals. Heart attacks can happen anytime, even during rest or sleep.

Associated symptoms: Cold sweat (very common), nausea vomiting (easily mistaken for stomach issues), breathing difficulty, palpitations, dizziness, sense of impending death, extreme anxiety.

If chest pain has these characteristics, call 120 immediately, don't hesitate:

Chest pain persisting over 15-20 minutes without relief.

Chest pain with cold sweat, breathing difficulty, nausea vomiting.

Chest pain radiating to left shoulder, left arm, neck, jaw.

History of heart disease (angina, myocardial infarction, coronary stents, bypass surgery).

Cardiovascular risk factors (hypertension, diabetes, high lipids, smoking, obesity, family history of cardiovascular disease).

Age: men >45, women >55 have significantly increased risk.

Remember: better false alarm than missed life-saving opportunity. Emergency doctors would rather treat 100 non-heart attack chest pains than miss one true heart attack.

Chest pain isn't necessarily heart attack—many other diseases can cause chest pain. Learning to differentiate helps reduce unnecessary anxiety, but前提is first excluding the most dangerous conditions.

Pneumothorax is lung rupture causing air leak into chest cavity, compressing the lung. Characteristics: sudden pleuritic pain (sharp, worse with breathing), breathing difficulty. Tall, thin young men are prone to spontaneous pneumothorax.

Aortic dissection is one of the most dangerous chest pain causes. Aortic intimal tear, blood enters aortic media creating true and false lumens. Characteristics: sudden, severe, tearing chest pain radiating to back. Pain at maximum intensity from onset, extremely severe. This is medical emergency, high mortality, needs immediate medical attention.

Pulmonary embolism is thrombus blocking pulmonary artery or its branches. Characteristics: sudden breathing difficulty, pleuritic chest pain, coughing blood (hemoptysis), tachycardia. People with deep vein thrombosis risk (recent surgery, long flights, cancer, pregnancy) at higher risk.

Esophageal spasm or GERD is digestive system disease but pain location similar to angina. Characteristics: "heartburn," acid reflux, pain related to position (worse when lying flat), occurs after meals.

Costochondritis is chest wall inflammation, characteristics: localized chest wall tenderness, pressing reproduces or worsens pain. This is benign condition, though pain may be severe, not life-threatening.

Musculoskeletal chest pain originates from muscles, ribs, sternum inflammation or strain. Characteristics: pain related to specific movements or positions, pressing specific area reproduces pain.

Chest pain differential diagnosis is complex. Use our Symptom Checker tool below to help you preliminarily assess chest pain risk level.

Enter your chest pain characteristics—location, quality, duration, triggers, relieving factors, associated symptoms—and the system will tell you risk level, whether you need immediate medical attention, possible disease directions.

But remember: for chest pain, online assessment never replaces doctor judgment. If symptoms match heart attack characteristics, or you're concerned, go directly to hospital or call 120, don't rely on online tools.

If you go to ER for chest pain, remember these points:

Tell doctor your symptom characteristics: when it started, pain location and quality, how long it lasted, any similar episodes before, any heart disease history and risk factors.

Get ECG: ECG is the fastest, most effective method for diagnosing heart attack. Normal ECG doesn't rule out heart attack (especially early), needs correlation with symptoms and cardiac enzymes.

Blood draw for cardiac enzymes: Troponin is currently the most sensitive cardiac injury marker. Starts rising 3-6 hours after heart attack, peaks 12-24 hours.

Get CT or ultrasound: if suspecting aortic dissection, pulmonary embolism or other diseases, doctor will arrange appropriate imaging.

Don't refuse hospitalization: if doctor recommends hospital observation or treatment, don't refuse. First few hours after heart attack are golden treatment time—earlier vessel opening, more myocardium salvaged, better prognosis.

About chest pain, many fatal misconceptions:

Misconception one: without "typical" chest pain, it's not heart attack. Fact: women, elderly, diabetics may present atypical heart attacks—only breathing difficulty, nausea vomiting, fatigue, even no chest pain. Don't ignore because symptoms "don't match textbook."

Misconception two: young people don't get heart attacks. Fact: while heart attacks more common in middle-aged and elderly, young people can also have heart attacks, especially with risk factors (smoking, obesity, family history) or specific diseases (coronary anomalies, Kawasaki disease history).

Misconception three: wait and see if it improves. Fact: with heart attack, time is myocardium, waiting won't make heart attack better, only causes more myocardial cell death. If suspecting heart attack, seek immediate medical attention.

Misconception four: drive yourself to hospital. Fact: if cardiac arrest occurs en route, no rescue in car. Call 120—ambulance has rescue equipment and professionals, can perform CPR during transport.

Chest pain is one of the body's most urgent signals. It could be heart attack—one of the deadliest diseases, or could be relatively benign conditions.

Learn to recognize heart attack chest pain characteristics, know when to call emergency services—could save your life in critical moments. Remember: better false alarm than missed life-saving opportunity. For chest pain, caution is always right.

Next time you experience chest pain, don't hesitate. Assess symptom characteristics, use our symptom checker tool for preliminary judgment, but if in doubt, seek medical attention directly.

Use our Symptom Checker tool above to understand possible causes of chest pain. Remember, chest pain can't wait—time is myocardium, time is life.