--- title: "Chest pain: when should it be checked by a cardiologist?" description: "Which features of chest pain matter, when to call 999, and what a private cardiology assessment in Brighton or London involves." url: "https://www.drmartins.org/symptoms/chest-pain/" author: "Dr Joao Martins" medical_reviewer: "Dr Joao Martins" review_status: "approved" date_published: "2026-09-01" date_modified: "2026-09-01" --- # Chest pain: when should it be checked by a cardiologist? Chest pain can come from the heart, but also from the lungs, the digestive system, the chest wall, or anxiety. Pain that is sudden, severe or persistent, or that comes with sweating, nausea, breathlessness or pain spreading to the arm, jaw, back or stomach, needs emergency assessment. Chest discomfort that is new, recurring, brought on by exertion, or otherwise unexplained should be assessed properly. A cardiology consultation can establish how likely a cardiac cause is, and which tests, if any, would genuinely change what happens next. ## When to seek urgent help Call 999 if chest pain is sudden or severe, lasts more than 15 minutes, or occurs together with sweating, nausea, feeling faint, breathlessness, or pain spreading to the arm, jaw, neck, back or stomach. Do not drive yourself to hospital. ## Key facts - Discomfort that comes on with exertion and settles within a few minutes of rest is the pattern most associated with coronary artery disease. - An ECG that is normal between episodes does not rule out coronary disease. - Risk factors such as age, family history, blood pressure, cholesterol, diabetes and smoking change how any given symptom should be interpreted. ## Why the description matters more than the intensity People often assume that severe pain means a serious cause and mild discomfort does not. In cardiology that is not reliable. What carries more information is the pattern: where the discomfort is, what it feels like, how long it lasts, what brings it on and what relieves it. Discomfort that appears predictably with exertion, walking uphill or climbing stairs, and eases within a few minutes of stopping, is the classic pattern of angina caused by narrowed coronary arteries. Discomfort that lasts a second or two, that can be reproduced by pressing on the chest wall, or that changes clearly with breathing or position, more often has a non-cardiac explanation. Neither pattern is absolute, which is why the assessment considers the symptom alongside everything else. ## What a cardiologist will ask A consultation usually begins with a detailed account of the symptom itself, followed by your wider medical history, current medicines and family history. Cardiovascular risk factors matter here: age, blood pressure, cholesterol, diabetes, smoking history and any previous cardiac events all change the probability that a given symptom is cardiac. It is helpful to arrive with a short note of what you have noticed. When episodes started, how often they happen, how long they last, what you were doing at the time and whether anything reliably brings them on or settles them is more useful than trying to recall it under pressure. ## What the assessment may involve Examination is the starting point, usually with a resting ECG. An ECG records the electrical activity of the heart at a single moment; it can show important abnormalities, but a normal recording between episodes does not exclude coronary disease. Depending on what the history suggests, further investigation may be considered. This can include blood tests, an echocardiogram to look at the structure and function of the heart, or imaging of the coronary arteries with a cardiac CT or invasive coronary angiogram. Tests are chosen to answer a specific question rather than as a routine panel, and each one is discussed before it is arranged. ## Non-cardiac causes are common Chest discomfort frequently comes from the oesophagus and stomach, from the muscles and joints of the chest wall, from the lungs, or from anxiety and panic. These are genuine causes of real symptoms, and identifying them properly is part of the assessment rather than a way of dismissing it. Where the picture points away from the heart, that conclusion is explained, and so is what to do next. ## What you should expect to leave with A useful consultation ends with an explanation you can repeat to someone else: what the likely explanation is, how confident that conclusion is, what would change it, and what to do if symptoms alter. Where treatment or further investigation is appropriate, the reasoning, the alternatives and the limitations are set out before any decision is made. ## Sources - [Chest pain](https://www.nhs.uk/conditions/chest-pain/) — NHS - [Recent-onset chest pain of suspected cardiac origin (CG95)](https://www.nice.org.uk/guidance/cg95) — NICE --- General information only. It does not replace individual medical advice, diagnosis or emergency care. In an emergency call 999.