Chest pain: Red Flags & Emergency Signs
Chest pain is one of the most time-critical symptoms in medicine — several life-threatening conditions present with chest pain and require immediate emergency assessment.
If you have this symptom right now
Call 999 (UK) / 112 (EU) / 911 (US) immediately if any emergency warning signs are present. Do not drive yourself. Do not wait to see if it improves.
🚨 Call 999 / 112 Immediately
- ⚠Crushing, squeezing, or pressure-like pain radiating to jaw, left arm, or back — call 999/112 immediately (heart attack)
- ⚠Sudden sharp chest pain with breathlessness and one-sided pleuritic quality — possible pulmonary embolism
- ⚠Sudden tearing or ripping pain radiating to the back — possible aortic dissection (surgical emergency)
- ⚠Chest pain with sudden breathlessness and absent breath sounds on one side — tension pneumothorax
- ⚠Chest pain with collapse, low blood pressure, or loss of consciousness
- ⚠Chest pain with new sweating, nausea, and pallor in anyone over 40
⚡ See a Doctor Today
- •Chest pain lasting >15 minutes not relieved by rest or GTN
- •Chest pain in a patient with known coronary artery disease, diabetes, or prior MI
- •Chest pain with palpitations or irregular pulse
- •Pleuritic chest pain (worse on inspiration) in patient with recent immobility or long-haul travel
High-Risk Combinations
When chest pain occurs together with any of these symptoms, urgency increases significantly:
Classic MI or PE presentation — 999 immediately
Diaphoresis with chest pain = MI until proven otherwise
Referred pain from inferior MI — do not dismiss
Classic left-arm radiation in MI
Chest pain with arrhythmia — possible VT or PE
Conditions to Rule Out Urgently
Most common life-threatening cause; ECG + troponin required
D-dimer + CTPA; Wells score ≥5 = high probability
BP difference between arms; CXR widened mediastinum
CXR; tension pneumothorax = immediate needle decompression
Beck's triad: hypotension, JVD, muffled heart sounds
ECG required; VT/VF = immediate defibrillation
Condition Authority Pages
Differential diagnosis analyses:
Side-by-side comparisons:
When to Call Emergency Services
- →Any chest pain with breathlessness, sweating, or collapse — call 999/112 now
- →Chest pain lasting more than 15 minutes at rest
- →Chest pain with a tearing sensation radiating to the back
- →Chest pain with loss of consciousness or very low blood pressure