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Dr. Chrysoula I. Liakou MD, PhD
Call 112 now if any of these apply
Call 112 immediately, and do not drive yourself, if chest pain:
- feels like pressure, squeezing, heaviness or tightness in the centre of the chest, especially if it lasts more than a few minutes or comes and goes;
- spreads to your arm, jaw, neck, back or upper stomach;
- comes with breathlessness, sweating, nausea, light-headedness or a sense of dread;
- is sudden and sharp with severe breathlessness, or follows recent surgery, immobility, a long journey or pregnancy (possible lung clot);
- comes with coughing up blood, fainting, or an irregular racing heartbeat;
- occurs in someone with known heart disease and does not settle promptly with their usual treatment.
A heart attack can be mild or atypical, particularly in women, older people and people with diabetes.[2] If in doubt, treat it as an emergency: calling 112 for chest pain that turns out to be harmless is the correct use of 112.
- Treated online: Only chest pain with no emergency features, such as chest-wall, reflux-type or infection-related pain, is assessed online; pain that could be cardiac is a 112 call, and ruling out a heart attack needs an ECG and blood tests.
- What it is: pain anywhere between the neck and the top of the abdomen; the commonest causes in adults are the chest wall (muscles and rib joints), acid reflux, anxiety and chest infections, with heart causes in roughly 1 in 7 people who see a doctor about it.
- Cardiac pattern: pressure, tightness or heaviness in the centre of the chest, brought on by exertion and eased by rest, or lasting a quarter of an hour or more, often with sweating, nausea or breathlessness; treated as angina or a heart attack until proven otherwise.
- Chest-wall pattern: sharp or aching pain that is worse when you press on it, twist, or take a deep breath, often after coughing, lifting or exercise; costochondritis at the rib joints is the classic example.
- How long: chest-wall pain settles over days to a few weeks with anti-inflammatories and normal movement; reflux pain eases within days of acid treatment and dietary change.
- Emergency: call 112 now for chest pain that is pressing or heavy, spreads to the arm, jaw or back, lasts a quarter of an hour or more, or comes with sweating, nausea, breathlessness, faintness or a racing irregular pulse.
A video consultation is appropriate only when none of the emergency features above apply, and it is never the route for pain happening right now that could be cardiac. If all of those features are absent, an online doctor can help you work out what your chest pain is and what to do about it.
Can an online doctor assess chest pain?
Only chest pain without emergency features. Pain with pressure, spreading, sweating, breathlessness or faintness needs 112, not a video call. When those features are absent, an online doctor can assess whether chest pain fits the chest wall, acid reflux, a chest infection or anxiety, treat what is safe to treat, and direct any tests needed.
The honest limits sit in plain sight: no video call can record an ECG or run the blood tests that rule a heart attack in or out. That is why this service's first job with chest pain is sorting, and its promise is direction rather than reassurance on demand. If your story raises cardiac risk, you will be told to be seen in person, even if you feel fine by the end of the call.
How an online consultation helps with chest pain
- Pattern sorting, done properly: where it hurts, what brings it on, what reproduces it. For non-emergency pain, the story separates chest-wall pain from reflux from infection more powerfully than any single test.[3]
- Emergency screening first: every chest pain consultation starts with the 112 checklist above, and if your answers change the picture mid-call, the doctor stops and tells you to call 112 there and then.
- Treatment for the treatable: anti-inflammatory plans for chest-wall pain, acid suppression for reflux-type pain, and assessment of infection-related pain, each after proper assessment.
- The right test, not every test: if you need an ECG, an in-person examination or urgent cardiology review, you leave knowing which one, where to get it, and how urgently.
What the doctor checks in an online chest pain consultation
Chest pain assessment is nine parts history, and history works well by video. The doctor will typically check:
- The exact story: what you were doing when it started, whether it built over seconds, minutes or days, and how long each episode lasts.
- The character: sharp, burning, aching or pressing, and whether it has ever felt like a weight or a band.
- What changes it: pressing on the spot, twisting, deep breaths, swallowing, food, lying flat, exertion. Each answer moves the diagnosis.
- The exertion question: pain that comes on with effort, such as stairs or hills, and eases with rest is treated as angina until proven otherwise and needs prompt in-person cardiac assessment, even if you feel well between episodes.[1]
- Clot risk: recent surgery, immobility or long journeys, pregnancy, hormonal contraception, previous clots or active cancer, because sudden pleuritic pain plus these means emergency assessment.
- Associated symptoms: breathlessness, sweating, nausea, palpitations, fever, cough, or acid taste and burping.
- Your risk profile: age, smoking, blood pressure, cholesterol, diabetes and family history of early heart disease, which set the threshold for in-person tests.[1]
- Recent illness and strain: a week of hard coughing, new gym programmes, heavy lifting or a poor sleeping position, the usual authors of chest-wall pain.
- Stress and mood, honestly: anxiety genuinely causes chest pain, and it is diagnosed carefully after other causes are considered, never as a shortcut.
When is chest pain serious?
Chest pain is treated as serious when it has cardiac features: pressure or tightness, spread to arm, jaw or back, accompanying sweating, nausea, breathlessness or faintness, or onset during exertion. Pain that arrives with exercise and eases with rest is a warning pattern that needs prompt in-person cardiac assessment even when it passes fully.[1]
Two more patterns deserve naming. Sudden sharp pain that is worse on breathing in, with breathlessness, after surgery, immobility, long travel or in pregnancy, raises a lung clot: emergency assessment, not observation. And pain with fever and a productive cough belongs to the lungs rather than the heart; our chest infection page explains those warning signs in detail.
What causes chest pain that is not a heart attack?
Once emergency causes are excluded, most chest pain comes from four places: the chest wall (strained muscles and rib-joint inflammation), the gullet (acid reflux), the lungs (infection irritating the lung lining), and anxiety, which produces genuine physical pain. Each has a recognisable pattern, and matching your story to the right one is what the assessment does.[3][5]
Chest-wall pain
The most common finding once emergencies are excluded, especially in younger people: sharp or aching pain you can often point to with one finger, sore when pressed, worse with movement, twisting or deep breaths. Frequent culprits are muscle strain from coughing bouts, exercise or lifting, and costochondritis, an irritation of the joints between ribs and breastbone. It settles over days to a few weeks with anti-inflammatories and normal movement, and reproducible tenderness is exactly what the doctor checks with you on camera. A hard week of coughing is a classic trigger; if the cough itself will not settle, see our guidance on assessing a persistent cough.
Reflux and heartburn
A burning pain behind the breastbone, worse after meals, with alcohol or coffee, or on lying down, often with an acid taste or burping. It can convincingly mimic cardiac pain, which is why the emergency questions always come first. Once the pattern is clear, it responds well to eating changes and acid-suppressing treatment. Alarm features change the plan: difficulty or pain on swallowing, unintended weight loss, vomiting blood or black stools all need in-person tests promptly.
Infection-related and nerve pain
Pleurisy-type pain catches sharply on breathing in and usually travels with fever and cough; it needs examination when breathing is affected, and a fever that climbs or returns needs review in its own right, as our fever page explains. Separately, a one-sided burning or tingling band of skin pain in someone over 50 can be shingles announcing itself a few days before any rash appears.
Anxiety-related chest pain
Anxiety and panic produce real chest pain: muscle tension across the chest, a racing heart, over-breathing that brings tingling fingers and light-headedness, and a convincing sense of catastrophe. It is a genuine diagnosis, reached properly, after the cardiac and clot questions have been asked rather than instead of them. If this is your pattern, the doctor can say so with confidence and talk through what actually helps, which is treatment, not embarrassment.
How doctors sort chest pain: first steps and where care happens
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Pressure-type pain, spreading, with sweating, nausea or breathlessness | Emergency care | No | Call 112 now[2] |
| Pain on exertion that eases with rest, well in between | Possible angina: prompt in-person cardiac assessment and ECG | No, beyond initial direction | Promptly, even if currently pain-free[1] |
| Sharp pain, sore to press, worse on movement or deep breath, after coughing or strain | Chest-wall pain plan: anti-inflammatories, movement advice | Often yes, once emergency features are excluded | If it worsens, or breathlessness or fever joins it |
| Burning behind the breastbone after meals or lying down, acid taste | Reflux plan: eating changes plus acid suppression | Usually yes | Swallowing difficulty, weight loss, or bleeding signs |
| Pain with fever and productive cough, worse breathing in | Chest infection assessment | Sometimes, as triage | Examination if breathless, very unwell, or not improving |
No emergency features, but the pain is still there? A doctor can tell you in one consultation.
See available times →Treatment options for chest pain
What you can do yourself
For assessed chest-wall pain: paracetamol or ibuprofen if suitable for you, warmth on the sore area, gentle movement rather than guarding, and a pause on whatever strained it. For reflux-type pain: smaller and earlier evening meals, less alcohol and coffee, raising the head of the bed, and pharmacy antacids while the plan beds in. For any chest pain, stopping smoking changes the risk on every branch of this page at once.[4]
Prescription treatment
After assessment, the doctor can prescribe where it genuinely helps: a course of acid-suppressing treatment for reflux-pattern pain, anti-inflammatory treatment for chest-wall pain when pharmacy options are not enough, and antibiotics only where a bacterial chest infection is actually likely. Two honest limits: strong opioid painkillers are controlled medicines and are not prescribed online, and heart medicines are never started on the basis of a video call; suspected cardiac pain goes to in-person assessment first, every time.
When chest pain is assessed online, and when you need in-person care
Assessed and treated online: chest-wall pain with a clear mechanical story and no emergency features; reflux-pattern pain without alarm features; infection-related pain suitable for online care; anxiety-related pain, assessed properly rather than assumed; and follow-up of pain already assessed in person.
In-person care: anyone whose answers trip the emergency checklist, to 112 immediately, including mid-consultation; exertional pain, to prompt in-person cardiac assessment with an ECG;[1] possible lung clot stories, to emergency care the same day; reflux with alarm features, to in-person investigation; and persistent unexplained pain, to examination, because "probably nothing" is a conclusion that must be earned with tests, not guessed at through a screen.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about chest pain: a private video call from anywhere in Europe; the consultation always starts with the emergency checklist, worked through together.
- Leave knowing your next step: an honest assessment, a clear plan, and a direct referral when in-person care is the right call, or a full refund.
No sign-up needed
Chest pain can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call. If you have an emergency sign listed on this page, call 112 instead.
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Not sure this is the right page? Look up any symptom in the full symptom checker, or book and describe it to a doctor.
Frequently asked questions about chest pain
Should I call 112 or book an online consultation for chest pain?
Call 112 if the chest pain is pressing, squeezing or heavy, spreads to your arm, jaw or back, lasts a quarter of an hour or more, or comes with sweating, nausea, breathlessness or faintness. Book an online consultation only when none of those features are present and you want help working out a pain that fits the chest wall, reflux, anxiety or a chest infection.
What causes chest pain that is not a heart attack?
Most chest pain is not the heart. The commonest non-cardiac causes are chest-wall pain from strained muscles or costochondritis at the rib joints, acid reflux and oesophageal spasm, anxiety and panic, chest infections and pleurisy, shingles before the rash appears, and gallbladder or stomach problems felt in the chest. The pattern of the pain, plus the emergency questions, sorts them.
What does heart-related chest pain feel like?
Classically a pressure, tightness or heaviness in the centre of the chest, sometimes spreading to the arm, jaw, neck or back, often with sweating, nausea or breathlessness, and typically brought on by exertion or stress. But heart attacks can be atypical, especially in women, older people and people with diabetes, where chest pain may be mild or replaced by breathlessness, nausea or exhaustion; any doubt means 112.
Can an online doctor rule out a heart attack?
No. Ruling out a heart attack needs an ECG and blood tests, which no video call can provide. What an online doctor can do with chest pain is recognise a story that needs those tests and direct you to them without delay, and, for pain that clearly fits the chest wall or reflux, treat it and spare you an unnecessary emergency visit.
Why does my chest hurt when I press on it?
Chest pain you can reproduce by pressing usually comes from the chest wall: strained muscles after coughing, exercise or lifting, or costochondritis at the rib joints. That pattern is reassuring, and it usually settles over days to weeks with anti-inflammatories and normal movement rather than guarding. Pain that also comes with exertion, sweating or breathlessness is still checked as cardiac.
Why does my chest hurt when I breathe in?
Chest pain that is sharp and worse on breathing in usually comes from the chest wall or from the lining of the lung: a strained muscle, costochondritis, pleurisy after a chest infection, or, less often, a blood clot in the lung. Pleuritic pain with breathlessness, a fast pulse, coughing blood, a swollen leg or recent immobility needs urgent in-person assessment; without those, it is usually treated with anti-inflammatories.
Can anxiety cause real chest pain?
Yes. Muscle tension, a racing heart and over-breathing produce genuine chest pain, sometimes frightening enough to feel cardiac. Doctors diagnose anxiety-related chest pain carefully, after the emergency and cardiac questions have been asked, never instead of them. Once confirmed, it responds to treatment of the anxiety: slow breathing, CBT and, where needed, medication.
Can acid reflux cause chest pain?
Yes. Acid reflux causes a burning or pressing chest pain behind the breastbone, often after meals or lying down, with a sour taste, burping or a cough, and it eases with antacids. Oesophageal spasm can mimic cardiac pain closely. Reflux-type chest pain is treated online with acid suppression and dietary change, but a first episode with cardiac features is still a 112 call.
How long does chest-wall pain last?
Chest-wall pain from a strained muscle or costochondritis usually settles over one to three weeks, sometimes longer when coughing keeps re-straining it. Anti-inflammatories, heat and continuing to move normally speed recovery; guarding and resting the chest prolong it. Chest pain that changes character, comes with exertion or lasts beyond six weeks needs re-assessment.
What can I do at home for non-cardiac chest pain?
For chest-wall pain, take an anti-inflammatory such as ibuprofen if it is safe for you, apply heat, keep moving and avoid heavy lifting for a week or two. For reflux-type chest pain, eat smaller meals, avoid eating within three hours of bed, raise the head of the bed and cut alcohol and coffee. For anxiety-related chest pain, slow your breathing out. Any new cardiac-type chest pain overrides all of this: call 112.
How can I reduce my risk of heart-related chest pain?
Reduce the risk of cardiac chest pain by not smoking, keeping blood pressure, cholesterol and blood sugar checked and treated, exercising regularly, keeping weight in range, limiting alcohol and managing stress and sleep. Anyone over 40, or with diabetes, a family history of early heart disease or high blood pressure, benefits from a cardiovascular risk check, which an online doctor can arrange.
Is chest pain different in women, older people or pregnancy?
Yes. Women and older people more often have heart attacks without classic chest pain, with breathlessness, nausea, sweating or sudden exhaustion instead, so those symptoms alone can mean 112. In pregnancy, chest pain is most often reflux or rib strain, but breathlessness with chest pain can signal a blood clot, which is commoner in pregnancy and needs urgent in-person assessment.
- Recent-onset chest pain of suspected cardiac origin: assessment and diagnosis (CG95), NICE, National Institute for Health and Care Excellence, 2010 (updated 2016).
- 2023 ESC Guidelines for the management of acute coronary syndromes, ESC, European Society of Cardiology, 2023.
- Chest pain, NICE Clinical Knowledge Summaries, revised 2024.
- Cardiovascular diseases (CVDs) fact sheet, WHO, World Health Organization, 2023.
- Chest pain, HSE, Health Service Executive (Ireland), accessed August 2026.
- Chest pain, NHS, National Health Service (UK), accessed October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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