Chest Pain

Chest pain doesn’t always mean that you’re having a heart attack. But that’s what emergency medical help usually tests for first because it can be life-threatening. Your healthcare professionals also will check for life-threatening lung conditions — such as a collapsed lung or a blood clot in the lung.

Immediate tests

Some of the first tests done to diagnose the cause of chest pain are:

• Electrocardiogram (ECG or EKG). This quick test shows how the heart is beating. The test can tell if you have had or are having a heart attack. Sticky patches with sensors on them go on the chest and sometimes the arms and legs. Wires connect the sensors to a computer, which prints or displays results.
• Blood tests. Certain heart proteins and other substances slowly leak into the blood after heart damage from a heart attack. Blood tests can be done to check for these.
• Chest X-ray. An X-ray of the chest shows the condition of the lungs and the size and shape of the heart. A chest X-ray can diagnose pneumonia or a collapsed lung.
• Computerized tomography (CT) scan. A CT scan uses X-rays to create cross-sectional images of specific parts of the body. A CT scan of the chest can spot a blood clot in the lung or find an aortic dissection.

Follow-up tests

Depending on the results from the first tests for chest pain, you may need more testing, which may include:

• Echocardiogram. Sound waves create images of the beating heart. This test shows how blood moves through the heart and heart valves.
• CT coronary angiogram. This test looks at the arteries that supply blood to the heart. It uses a powerful X-ray machine to make images of the heart and its blood vessels. The test is used to diagnose many different heart conditions.
• Exercise stress test. For this test, you walk on a treadmill or ride a stationary bike while a healthcare professional watches the heartbeat. Exercise tests help show how the heart reacts to exercise. If you can’t exercise, you might get medicines that affect the heart like exercise does.
• Coronary catheterization. This test can find blockages in the heart arteries. A long, thin flexible tube is inserted into a blood vessel, usually in the groin or wrist, and guided to the heart. Dye flows through the tube to arteries in the heart. The dye helps the arteries show up more clearly on X-ray images and video.