Cardiac Condition Information

    Chest Pain

    Chest pain is one of the most common reasons for urgent medical attention. It is a symptom, not a diagnosis — the underlying cause must be established through proper assessment, as symptoms alone cannot reliably distinguish a pulled muscle from a heart attack.

    Dr Matthew Balerdi offers rapid assessment for chest pain in Hull, Grimsby and Scunthorpe, including same-week ECG, echocardiography, CT coronary angiography, and stress echocardiography.

    When Chest Pain May Be Cardiac

    Not all chest pain is cardiac, but certain features raise concern and warrant further investigation. Features that suggest a possible cardiac origin include:

    • Tight, heavy, or squeezing character
    • Central or left-sided location
    • Radiation to the arm, jaw, neck, or back
    • Associated breathlessness, sweating, or nausea
    • Provoked by exertion or physical activity

    Atypical Presentations

    It is important to recognise that chest pain does not always present in a classic pattern. Women, the elderly, and people with diabetes are more likely to experience atypical symptoms such as fatigue, breathlessness, upper back pain, or discomfort in the jaw or arm without obvious chest tightness. A "normal" sounding description does not guarantee a benign cause.

    Causes of Chest Pain

    Chest pain has many possible causes. Establishing the correct diagnosis is essential because treatment depends entirely on the underlying condition.

    Cardiac

    • Angina (stable and unstable)
    • Acute coronary syndrome / heart attack
    • Pericarditis
    • Myocarditis
    • Aortic dissection

    Respiratory

    • Pulmonary embolism
    • Pneumothorax
    • Pneumonia
    • Pleurisy

    Gastrointestinal

    • Gastro-oesophageal reflux disease (GORD)
    • Oesophageal spasm
    • Peptic ulcer disease

    Musculoskeletal

    • Costochondritis
    • Muscle strain
    • Tietze syndrome

    How Chest Pain Is Investigated

    A structured approach to investigation ensures the correct diagnosis is reached efficiently and safely.

    Initial Assessment

    Detailed clinical history, 12-lead ECG, and blood tests including troponin, D-dimer, full blood count, and lipid profile to identify or exclude acute causes.

    Cardiac Imaging

    Echocardiogram to assess cardiac structure and function. CT coronary angiogram is recommended by NICE as the first-line investigation for stable chest pain of suspected cardiac origin.

    Stress Testing

    Stress echocardiography or myocardial perfusion scintigraphy when CT coronary angiography is inconclusive or in patients with known coronary artery disease.

    When to Seek Urgent Help

    Call 999

    • Sudden severe chest pain
    • Chest pain with breathlessness, sweating, or collapse
    • Tearing pain radiating to the back

    Urgent Review

    • New unexplained chest pain
    • Known angina with a changed pattern of symptoms

    Routine Appointment

    • Recurrent exertional discomfort
    • Abnormal ECG requiring further investigation
    • Wanting reassurance about cardiac health

    Reviewed by Dr Matthew Balerdi, Consultant Imaging Cardiologist (FRCP) — Last reviewed: April 2026

    Concerned About Chest Pain?

    Chest pain should always be taken seriously. Early investigation can provide reassurance or identify treatable conditions before they become emergencies. Schedule your assessment today.