The Signs Your Chest Pain Could Be a Heart Attack

Here’s how to tell if your chest aches spell heart trouble.

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You feel a lingering, dull, and burning sensation in your chest. You suspect it’s heartburn, but a small part of you can’t help but wonder: Could I be having a heart attack?

There are many non-heart related causes of chest discomfort—from pneumonia to panic attacks to indigestion. So how can if your tell if your chest pain is a sign of a heart attack? “I’ve often been asked about how you can differentiate heart attack pain from non-heart attack pain—it’s very difficult,” says cardiologist Nieca Goldberg, MD, medical director at NYU Langone Health in New York.

Chest Pain Symptoms: More Likely to Be a Heart Attack

Chest pain from a heart attack can feel like tightness, pressure, or squeezing. Heart attack chest pain may also gradually get worse over the course of a few minutes, and could be felt over a widespread area of the chest. “Sometimes people explain it as a tiredness in the chest, some people say it’s sharp,” says Dr. Goldberg. There are more heart attack clues to look out for besides chest pain, too. You may also feel sudden nausea, shortness of breath, cold sweats or pain that extends to the left arm, neck, jaw, or back.

Chest Pain Symptoms: Less Likely to Be a Heart Attack

If you feel a sudden, sharp stabbing pain that lasts a few seconds or is brought on by coughing or breathing, it could be a sign of pericarditis (which is a heart condition, but not a heart attack) or it could be due to a respiratory condition, like asthma or pneumonia. If you feel a burning sensation in your chest, it could also be due to heartburn or indigestion. Other signs that your pain is less likely to be a heart attack are: pain that’s localized to a small spot, pain that lasts for hours or days without other symptoms, or pain that can be reproduced with certain movements.

But here’s the most important takeaway: “We cannot always make [a heart attack] diagnosis [only] by the quality of the chest pain,” says Dr. Goldberg. In other words, you can’t assume your heart is safe because your pain is presenting in a certain way. Many people experience heart attacks without that telltale crushing chest pain. When in doubt, call your doctor or 911.

You doctor will ask you specific questions to be able to understand the source of the chest pain. “The person who is not feeling well or having chest pain [needs to] be able to tell the doctor when it comes on, what provokes the symptoms, and if [they] do anything that makes it go away,” says Dr. Goldberg.

Whatever you’re feeling, if you even slightly suspect a heart attack, don’t take a chance. “My biggest advice to people, is when you have any of these symptoms, don’t delay having them evaluated,” says Dr. Goldberg. “Instead of waiting for your heart attack to wake you up from your sleep, you should go to the doctor when you begin to have these symptoms.”