Quick answer. Chest pain has many causes, from heart and lung problems to acid reflux or muscle strain. Crushing central chest pain that spreads to the arm or jaw with sweating or breathlessness is a medical emergency — call 995 immediately.
Chest pain is one of the most common reasons people seek urgent care in Singapore. While many causes are not life-threatening, some signal a heart attack or other emergency that needs immediate treatment.
This guide explains the common and serious causes of chest pain, the red flags that mean you should call 995, and which specialist to see for ongoing symptoms.
At a glance
| Possible cause | What it may suggest | Urgency |
|---|---|---|
| Crushing central pain spreading to arm, jaw or back with sweating | Heart attack or angina (heart muscle starved of blood) | Emergency – call 995 now |
| Sharp pain worse on breathing in, with breathlessness | Lung problem (e.g. clot, infection, collapsed lung) | Urgent – same-day care |
| Burning pain behind the breastbone, worse after meals or lying down | Acid reflux (GERD) or oesophageal spasm | See a doctor soon |
| Localised pain that hurts on pressing or moving | Muscle strain or rib/cartilage inflammation | Non-urgent, monitor |
| Tight chest with palpitations during stress or anxiety | Anxiety or panic-related chest pain | See a doctor to confirm |
What chest pain feels like
Chest pain can feel sharp, dull, burning, squeezing or like heavy pressure. It may stay in one spot or spread to the shoulder, arm, neck, jaw or back. The location, character and triggers help doctors work out the cause — but pain alone cannot reliably tell you whether it is the heart, so any unexplained or severe chest pain should be assessed.
When it's an emergency
Call 995 immediately if chest pain comes with any of these red flags:
- Crushing, heavy or tight central chest pain lasting more than a few minutes
- Pain spreading to the arm(s), jaw, neck, shoulder or back
- Cold sweat, nausea, dizziness or a feeling of impending doom
- Sudden severe breathlessness or fainting
- Pain with an irregular or very fast heartbeat
These can signal a heart attack, which is most survivable when treated within the first hour. Do not drive yourself — call 995 for an ambulance. If the person collapses and is not breathing normally, start CPR.
Common (less serious) causes
Many cases of chest pain are not caused by the heart. Acid reflux can cause a burning pain behind the breastbone, often after meals or when lying down. Muscle or rib strain causes pain that worsens with movement or pressing on the area. Anxiety and panic attacks can cause chest tightness with rapid breathing. These still deserve a doctor’s assessment to rule out serious causes first.
Serious causes to rule out
Beyond heart attack and angina, serious causes include a blood clot in the lung (pulmonary embolism), a collapsed lung (pneumothorax), pneumonia, and — rarely — a tear in the main artery (aortic dissection). These typically cause sudden, severe pain often with breathlessness and need emergency assessment. Tests such as an ECG, blood tests, chest X-ray and sometimes a CT scan help identify the cause.
Which specialist should you see?
For ongoing or recurrent chest pain that is not an emergency, your GP can examine you and arrange first-line tests. If a heart cause is suspected, see one of the cardiologists for an ECG, echocardiogram or stress test. If the pain seems linked to breathing or the lungs, the respiratory physicians can investigate further. Reflux-related pain is often managed by a GP or gastroenterologist.
How chest pain is diagnosed
Doctors start with your history and a physical examination, then commonly order an ECG to check the heart’s rhythm and blood tests (including troponin) to detect heart muscle damage. A chest X-ray, echocardiogram, treadmill stress test or CT scan may follow depending on the suspected cause. Keeping a note of when pain occurs, what triggers it and how long it lasts helps your doctor reach a diagnosis faster.
What to expect at the appointment
For chest pain that is not an emergency, your doctor will ask you to describe the pain in detail: where it is, what it feels like, how long it lasts, what brings it on, and whether it spreads to the arm, jaw, neck or back. They will ask about breathlessness, sweating, palpitations, reflux symptoms, and risk factors such as smoking, high blood pressure, diabetes, cholesterol and family history of heart disease. Expect a physical examination, an ECG to check the heart’s rhythm, and often blood tests. Depending on the findings, a chest X-ray, echocardiogram, treadmill stress test or CT scan may follow. Keeping a note of when the pain occurs and what triggers it helps your doctor reach a diagnosis sooner.
How to prepare and self-manage
Know your personal risk factors and bring a list of your medicines and any family history of early heart disease, as this shapes how chest pain is interpreted. For pain that seems clearly linked to reflux, such as a burning sensation after meals or when lying down, simple measures can help: eat smaller meals, avoid eating late at night, limit alcohol and very fatty or spicy food, and raise the head of the bed. Muscle or rib strain that hurts on pressing or moving usually eases with rest and time. These steps are reasonable only once a doctor has ruled out a heart or other serious cause; never assume chest pain is harmless.
Special situations
Some people have heart attacks without the classic crushing pain. Women, older adults and people with diabetes may instead feel breathlessness, nausea, sweating, fatigue or discomfort in the jaw, back or upper abdomen, and these atypical symptoms can be easy to dismiss. If you have known heart disease and your usual angina becomes more frequent, comes on with less effort, or no longer settles with rest or your prescribed spray, treat this as urgent. When in doubt with severe or unexplained chest pain, call 995 rather than driving yourself, as treatment is most effective when given early.
Common questions
How do I tell heart pain from reflux or muscle strain?
You often cannot tell reliably from the feeling alone, which is why any unexplained or severe chest pain should be assessed. Pain that is crushing, spreads to the arm or jaw, or comes with sweating and breathlessness is treated as a heart emergency.
What should I do if someone collapses with chest pain?
Call 995 immediately. If the person is not breathing normally, start CPR and continue until help arrives; an ambulance can also direct you to the nearest defibrillator.
Related guides
- Best Cardiology Clinics in Singapore — our editorial shortlist
- cardiology clinics directory
- Shortness of breath
- Difficulty swallowing
- Abdominal pain
Sources
- HealthHub Singapore – Chest Pain
- SingHealth – Heart Attack (Myocardial Infarction)
- Singapore Heart Foundation – Heart Attack Symptoms
- NHS – Chest Pain
- Mayo Clinic – Chest Pain
Part of our Heart & vascular guides · Browse all health topics