Health education · HeartSaint‑Hyacinthe
Chest pain: when to seek care and how it is assessed in Saint-Hyacinthe
Pain, pressure, tightness or a burning sensation in the chest can have several causes. Some are benign, but others require urgent medical assessment.
At Clinique IPS du Palais, our team can support some people with stable, non-urgent chest pain, depending on the clinical context.
Understanding
What is chest pain?
The term chest pain refers to any discomfort felt in the chest area. The sensation can be described in several ways:
Pressure or heaviness
Tightness or constriction
Burning
Pinching
Pain with movement or deep breathing
The location of the pain and the way it feels cannot, on their own, determine its cause.
Origin
Does chest pain always come from the heart?
No.
Some chest pain may have a cardiovascular origin, while other chest pain may be musculoskeletal, respiratory or digestive.
However, it is important not to conclude on your own that pain is benign just because it feels like muscle pain or heartburn.
The chest contains several structures that can cause pain:
- heart;
- lungs;
- muscles;
- ribs;
- joints;
- esophagus;
- digestive system;
- nerves.
Possible causes
What can cause chest pain?
Cardiovascular causes
Certain diseases of the heart or blood vessels can cause pain or discomfort in the chest. These may include:
- coronary artery disease;
- angina;
- myocardial infarction;
- certain types of inflammation around the heart;
- certain diseases of the aorta.
These conditions do not all have the same presentation or the same level of urgency.
Musculoskeletal causes
Pain can come from the chest muscles, the ribs, the joints, local inflammation, unusual exertion or an injury.
Pain reproduced by certain movements or by pressing on the area can sometimes point to a musculoskeletal cause.
However, this alone is not enough to rule out another cause.
Respiratory causes
Some lung diseases can also cause chest pain. Depending on the context, it may be accompanied by:
- shortness of breath;
- cough;
- fever;
- wheezing;
- pain that gets worse with deep breathing.
Severe difficulty breathing is an urgent situation.1
Digestive causes
Gastroesophageal reflux and certain other digestive conditions can cause:
- a burning feeling behind the breastbone;
- chest discomfort;
- acid regurgitation;
- symptoms after meals.
However, pain that feels like heartburn does not automatically rule out a cardiac cause.3
Stress and anxiety
Stress or anxiety can be accompanied by chest tightness, a faster heart rate, palpitations, a feeling of not getting enough air or rapid breathing.
Before attributing new chest pain to anxiety, particularly when cardiovascular risk factors are present, an assessment may be necessary.
Chest pain on exertion
Pain or discomfort that appears during physical exertion deserves particular attention. Tell the professional if symptoms occur when you walk quickly, climb stairs, carry a load, play sports or do physical work.
Also mention whether the symptoms go away when you stop the exertion.
New or significant chest pain brought on by exertion should not be dismissed.
What details are important during the assessment?
The professional may ask you:
- where the pain is located;
- when it started;
- how long it lasts;
- whether it is constant or intermittent;
- how you would describe it;
- what triggers it and what relieves it;
- whether it occurs on exertion;
- whether it gets worse when you breathe deeply;
- whether it is affected by movement;
- whether it appears after meals;
- whether it spreads elsewhere in the body.
Associated symptoms are also very important.
What symptoms can accompany the pain?
Depending on the cause, chest pain may be accompanied by, among other things:
- shortness of breath;
- palpitations;
- sweating;
- nausea;
- dizziness;
- unusual fatigue;
- weakness;
- cough;
- fever;
- pain in an arm, a shoulder, the back, the jaw or the neck.
The combination of symptoms helps determine the level of urgency and the tests needed.
Heart attack
Are symptoms always typical during a heart attack?
No.
A heart attack does not always cause sudden or dramatic pain.3
Some people can even have a heart attack without significant chest pain. It is therefore essential to consider all of the symptoms and the context.
Some people may feel:
- pressure;
- heaviness;
- a burning sensation;
- relatively mild discomfort;
- shortness of breath;
- nausea;
- unusual fatigue;
- dizziness.
Chest pain in women
Women can have a heart attack with chest pain or discomfort, as men do. However, other signs may sometimes be more prominent:3,4
- shortness of breath;
- unusual or extreme fatigue;
- nausea;
- dizziness;
- pain in the back, the jaw or the upper abdomen.
The absence of intense chest pain therefore does not rule out a cardiovascular emergency.
Chest pain and palpitations
Chest pain can sometimes be accompanied by a feeling that the heart is racing, irregular or very strong beats, pauses or extra beats.
When palpitations are intermittent and the situation is not urgent, a heart rhythm investigation may sometimes be indicated.
Test
The electrocardiogram (ECG)
An electrocardiogram (ECG) records the heart’s electrical activity.4
At Clinique IPS du Palais, we can perform a 12-lead ECG when this test is indicated in a situation appropriate for outpatient care.
- Rate and rhythmHeart rate and rhythm.
- Electrical abnormalitiesCertain electrical abnormalities of the heart.
- To investigateCertain abnormalities that may require further investigation.
Does a normal ECG rule out a heart attack?
No.
An ECG is one part of the assessment. A person can have a serious cardiovascular problem even if an initial ECG does not show certain typical abnormalities.
When acute coronary syndrome is suspected, the assessment may require, among other things, repeated ECGs, blood tests such as troponins, medical monitoring and other tests.4 These assessments are carried out in an appropriate setting, such as the emergency department.
The ECG available at the clinic should therefore not be used to delay going to the emergency department when symptoms are worrying.
Choosing the test
ECG or CardioSTAT?
These tests do not have exactly the same purpose.
ECG
An ECG records the heart’s rhythm and electrical activity over a short period.
CardioSTAT
CardioSTAT allows extended recording of the heart rhythm. It can be relevant when looking for an intermittent arrhythmia, among other things.
However, CardioSTAT is not a tool intended to replace the urgent assessment of acute chest pain.
Risk factors
What are the cardiovascular risk factors?
Your level of cardiovascular risk influences how symptoms are interpreted.
During an assessment, it may be relevant to look for, among other things:4
- high blood pressure;
- high cholesterol;
- diabetes;
- smoking;
- family history of cardiovascular disease;
- age;
- sedentary lifestyle;
- certain chronic diseases.
What should you do if the pain is new but stable?
New chest pain deserves particular attention. Even when it is not very intense, the following must be taken into account:
- your age;
- your medical history;
- your cardiovascular risk factors;
- how long the symptoms have lasted;
- the context in which they appeared;
- associated symptoms.
If you do not know which resource to consult and the situation does not seem urgent, Info-Santé 811, option 1, lets you speak with a nurse.2
When should you seek care quickly?
A prompt assessment is appropriate in the presence of, among other things:
- new chest pain;
- pain that keeps coming back;
- pain associated with exertion;
- pain accompanied by palpitations;
- unusual shortness of breath;
- a recent decrease in physical capacity;
- pain in a person with several cardiovascular risk factors.
However, the level of urgency must always be assessed based on the situation as a whole.
When should you call 911?
Call 911 if you think it could be a medical emergency.1,3
This includes, for example, significant chest pain or discomfort accompanied by:
- difficulty breathing;
- unusual sweating;
- nausea;
- significant dizziness;
- loss of consciousness;
- severe weakness;
- pain radiating to the arm, the jaw, the back, the neck or a shoulder;
- rapid worsening of your general condition.
If you are seriously in doubt when faced with significant symptoms, it is better to get an urgent assessment.
How can Clinique IPS du Palais support you?
When a situation is stable, non-urgent and appropriate for care at the clinic, our team can, among other things:
- review your symptoms;
- review your cardiovascular risk factors;
- measure your blood pressure;
- measure your heart rate;
- perform a physical examination;
- perform an ECG when indicated;
- order certain additional tests depending on the situation;
- provide follow-up;
- refer you to the emergency department or another professional when necessary.
Potentially urgent chest pain should not wait for a clinic appointment.
Frequently asked questions
Frequently asked questions
Does chest pain always mean a heart problem?
No. It may have a cardiovascular, pulmonary, musculoskeletal, digestive or other origin. However, certain serious causes must be ruled out when the context requires it.
Is pain that gets worse when I move necessarily muscular?
No. The fact that pain is affected by movement can guide the assessment, but it cannot on its own rule out a cardiovascular or other cause.
Is a burning feeling in the chest simply reflux?
Not necessarily. A burning feeling may be digestive, but a heart attack can also be felt as burning or chest discomfort.
Can an ECG tell immediately whether my heart is fine?
An ECG provides important information, but it cannot on its own rule out all cardiovascular diseases or a heart attack.
Why are blood tests sometimes done in the emergency department?
When an acute cardiac cause is suspected, tests such as troponins can help look for damage to the heart muscle.
Can chest pain and palpitations be related?
Yes. Some heart rhythm disorders can be accompanied by chest discomfort. These symptoms must be assessed according to their context and severity.
Can stress cause chest pain?
Yes, but new pain should not automatically be attributed to stress without considering the context and risk factors.
When should I call 811?
Info-Santé 811 is appropriate for a non-urgent health problem when you want a nurse’s advice and to be directed to the right resource.
When should I call 911?
When a situation seems urgent or potentially dangerous, for example in the case of significant chest pain with difficulty breathing, loss of consciousness or other worrying signs.
Sources
- Gouvernement du Québec. Quand consulter à l’urgence. Updated July 16, 2026, accessed October 6, 2026. quebec.ca
- Gouvernement du Québec. Info-Santé 811. Updated December 7, 2022, accessed October 6, 2026. quebec.ca
- Public Health Agency of Canada. Signes et symptômes d’une crise cardiaque. Modified February 12, 2026, accessed October 6, 2026. canada.ca
- Heart and Stroke Foundation of Canada (Heart & Stroke). Crise cardiaque. Undated page, accessed October 6, 2026. coeuretavc.ca
This page provides general information and does not replace an assessment by a health professional. Potentially urgent chest pain requires immediate care.