Chest pain

Potential location of pain from a heart attack
A blockage of coronary arteries can lead to a heart attack
Gastroesophageal reflux disease is a common cause of chest pain in adults

Pain or discomfort in the chest, typically the front of the chest.

- Chest pain
Potential location of pain from a heart attack

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A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.

Myocardial infarction

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.
Cross section showing anterior left ventricle wall infarction
Diagram showing the blood supply to the heart by the two major blood vessels, the left and right coronary arteries (labelled LCA and RCA). A myocardial infarction (2) has occurred with blockage of a branch of the left coronary artery (1).
A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the right coronary artery. Elevation of the ST segment can be seen in leads II, III and aVF.
ECG : AMI with ST elevation in V2-4
Inserting a stent to widen the artery.

The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw.

Shortness of breath

Uncomfortable feeling of not being able to breathe well enough.

Uncomfortable feeling of not being able to breathe well enough.

Acute coronary syndrome frequently presents with retrosternal chest discomfort and difficulty catching the breath.

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Troponin

Complex of three regulatory proteins that are integral to muscle contraction in skeletal muscle and cardiac muscle, but not smooth muscle.

Complex of three regulatory proteins that are integral to muscle contraction in skeletal muscle and cardiac muscle, but not smooth muscle.

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Troponin activation. Troponin C (red) binds Ca2+, which stabilizes the activated state, where troponin I (yellow) is no longer bound to actin. Troponin T (blue) anchors the complex on tropomyosin.

They are measured in the blood to differentiate between unstable angina and myocardial infarction (heart attack) in people with chest pain or acute coronary syndrome.

Heart

Muscular organ in most animals that pumps blood through the blood vessels of the circulatory system.

Muscular organ in most animals that pumps blood through the blood vessels of the circulatory system.

Human heart during an autopsy
Computer-generated animation of a beating human heart
The human heart is in the middle of the thorax, with its apex pointing to the left.
Heart being dissected showing right and left ventricles, from above
Frontal section showing papillary muscles attached to the tricuspid valve on the right and to the mitral valve on the left via chordae tendineae.
Layers of the heart wall, including visceral and parietal pericardium
The swirling pattern of myocardium helps the heart pump effectively
Arterial supply to the heart (red), with other areas labelled (blue).
Autonomic innervation of the heart
Development of the human heart during the first eight weeks (top) and the formation of the heart chambers (bottom). In this figure, the blue and red colors represent blood inflow and outflow (not venous and arterial blood). Initially, all venous blood flows from the tail/atria to the ventricles/head, a very different pattern from that of an adult.
Blood flow through the valves
The cardiac cycle as correlated to the ECG
The x-axis reflects time with a recording of the heart sounds. The y-axis represents pressure.
Transmission of a cardiac action potential through the heart's conduction system
Conduction system of the heart
The prepotential is due to a slow influx of sodium ions until the threshold is reached followed by a rapid depolarization and repolarization. The prepotential accounts for the membrane reaching threshold and initiates the spontaneous depolarization and contraction of the cell; there is no resting potential.
3D echocardiogram showing the mitral valve (right), tricuspid and mitral valves (top left) and aortic valve (top right).
The closure of the heart valves causes the heart sounds.
Cardiac cycle shown against ECG
Heart and its blood vessels, by Leonardo da Vinci, 15th century
Animated heart
Elize Ryd making a heart sign at a concert in 2018
The tube-like heart (green) of the mosquito Anopheles gambiae extends horizontally across the body, interlinked with the diamond-shaped wing muscles (also green) and surrounded by pericardial cells (red). Blue depicts cell nuclei.
Basic arthropod body structure – heart shown in red
The human heart viewed from the front
The human heart viewed from behind
The coronary circulation
The human heart viewed from the front and from behind
Frontal section of the human heart
An anatomical specimen of the heart
Heart illustration with circulatory system
Animated Heart 3d Model Rendered in Computer

Cardiovascular diseases frequently do not have symptoms or may cause chest pain or shortness of breath.

Illustration depicting angina

Angina

Illustration depicting angina
Diagram of discomfort caused by coronary artery disease. Pressure, fullness, squeezing or pain in the center of the chest. Can also feel discomfort in the neck, jaw, shoulders, back or arms.

Angina, also known as angina pectoris, is chest pain or pressure, a symptom of coronary heart disease, usually due to insufficient blood flow to the heart muscle (myocardium).

An ECG showing pericarditis. Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR.

Pericarditis

Inflammation of the pericardium, the fibrous sac surrounding the heart.

Inflammation of the pericardium, the fibrous sac surrounding the heart.

An ECG showing pericarditis. Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR.
Figure A shows the location of the heart and a normal heart and pericardium (the sac surrounding the heart). The inset image is an enlarged cross-section of the pericardium that shows its two layers of tissue and the fluid between the layers. Figure B shows the heart with pericarditis. The inset image is an enlarged cross-section that shows the inflamed and thickened layers of the pericardium.
Diffuse ST elevation in a young male due to myocarditis / pericarditis
An ECG showing pericarditis. Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR.
Ultrasounds showing a pericardial effusion in someone with pericarditis
A pericardial effusion as seen on CXR in someone with pericarditis

Symptoms typically include sudden onset of sharp chest pain, which may also be felt in the shoulders, neck, or back.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)

Arrhythmia

Too fast or too slow.

Too fast or too slow.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)
Broad classification of arrhythmias according to region of heart required to sustain the rhythm
Normal sinus rhythm, with solid black arrows pointing to normal P waves representative of normal sinus node function, followed by a pause in sinus node activity (resulting in a transient loss of heartbeats). Note that the P wave that disrupts the pause (indicated by the dashed arrow) does not look like the previous (normal) P waves – this last P wave is arising from a different part of the atrium, representing an escape rhythm.

In more serious cases, there may be lightheadedness, passing out, shortness of breath or chest pain.

The digestive tract, with the esophagus marked in red

Esophagus

Organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach.

Organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach.

The digestive tract, with the esophagus marked in red
The esophagus is constricted in three places.
A mass seen during an endoscopy and an ultrasound of the mass conducted during the endoscopy session.

Diseases may cause difficulty swallowing (dysphagia), painful swallowing (odynophagia), chest pain, or cause no symptoms at all.

Illustration depicting atherosclerosis in a coronary artery

Coronary artery disease

Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart.

Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart.

Illustration depicting atherosclerosis in a coronary artery
Clogged artery
Micrograph of a coronary artery with the most common form of coronary artery disease (atherosclerosis) and marked luminal narrowing. Masson's trichrome.
Illustration depicting coronary artery disease
Coronary angiogram of a man
Coronary angiogram of a woman
Deaths due to ischaemic heart disease per million persons in 2012

A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.

Chest X-ray of a pneumonia caused by influenza and Haemophilus influenzae, with patchy consolidations, mainly in the right upper lobe (arrow)

Pneumonia

Inflammatory condition of the lung primarily affecting the small air sacs known as alveoli.

Inflammatory condition of the lung primarily affecting the small air sacs known as alveoli.

Chest X-ray of a pneumonia caused by influenza and Haemophilus influenzae, with patchy consolidations, mainly in the right upper lobe (arrow)
Main symptoms of infectious pneumonia
The bacterium Streptococcus pneumoniae, a common cause of pneumonia, imaged by an electron microscope
Cavitating pneumonia due to MRSA as seen on a CT scan
A chest x-ray of a patient with severe viral pneumonia due to SARS
Pneumonia fills the lung's alveoli with fluid, hindering oxygenation. The alveolus on the left is normal, whereas the one on the right is full of fluid from pneumonia.
A chest X-ray showing a very prominent wedge-shaped area of airspace consolidation in the right lung characteristic of acute bacterial lobar pneumonia
CT of the chest demonstrating right-sided pneumonia (left side of the image)
A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.
Deaths from lower respiratory infections per million persons in 2012
WPA poster, 1936/1937
Pneumonia seen by ultrasound
Right middle lobe pneumonia in a child as seen on plain X-ray

Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing.