Symptom Combination

Chest Pain and Palpitations: Causes, Conditions & When to See a Doctor

Chest pain with palpitations suggests acute MI with ischemia-induced arrhythmia, aortic stenosis with ventricular arrhythmia, or supraventricular tachycardia causing chest discomfort. The combination raises concern for pre-excitation syndromes (WPW) with rapid AF and is associated with high mortality from VT/VF.

→ Chest Pain Overview → Palpitations Overview

Possible Causes of Chest Pain and Palpitations

Conditions that commonly cause both symptoms together

1Acute MI with ventricular ectopy or VT
2WPW syndrome with rapid atrial fibrillation
3Aortic stenosis with effort palpitations and chest pain
4Hypertrophic obstructive cardiomyopathy
5Anxiety disorder with PSVT and atypical chest discomfort

Emergency Red Flags

Seek immediate medical attention if you experience any of these

Regular rapid rate (150–300 bpm) with chest pain (VT or AVRT)

Hemodynamic instability during palpitations

Delta waves on ECG (pre-excitation)

Chest pain only during palpitation episodes

Family history of sudden death with palpitations

When to See a Doctor

Schedule a medical consultation if you notice these signs

Emergency evaluation for rapid sustained palpitations with chest pain

Ambulatory Holter if palpitations are paroxysmal

Echocardiography to exclude structural heart disease

Electrophysiology study if VT or WPW is suspected

Conditions That Cause Both Chest Pain and Palpitations

15 conditions are associated with this symptom combination

Hypertension (high blood pressure) is a condition where the force of blood against artery walls is consistently too high. Often called the 'silent killer', it usually has no symptoms but significantly increases the risk of heart attack, stroke, and kidney disease.

Anxiety Disorder

Anxiety disorders are among the most common mental health conditions, characterized by excessive fear, worry, or nervousness that interferes with daily activities. Types include generalized anxiety disorder (GAD), panic disorder, and social anxiety.

Heart Attack (Myocardial Infarction)

A heart attack occurs when blood flow to part of the heart muscle is blocked, usually by a blood clot in a coronary artery. Immediate treatment is critical. Symptoms include chest pain, pressure radiating to the arm or jaw, sweating, and nausea.

Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. It is a chronic condition that causes fatigue, shortness of breath, and fluid retention (edema). It requires ongoing medical management.

Cardiac Arrhythmia

Cardiac arrhythmia refers to irregular heart rhythms â€” the heart beats too fast, too slow, or with an irregular pattern. Some arrhythmias are harmless, while others (like atrial fibrillation) significantly increase the risk of stroke and heart failure.

Aortic Stenosis

Aortic stenosis is narrowing of the aortic valve opening, restricting blood flow from the heart. It causes exertional chest pain, syncope, and heart failure; valve replacement is required for severe symptomatic disease.

Mitral Valve Disease

Mitral valve disease includes mitral regurgitation (valve leaking) and mitral stenosis (valve narrowing), causing symptoms of breathlessness, fatigue, and palpitations. Rheumatic heart disease is a major cause worldwide.

Myocarditis is inflammation of the heart muscle, most commonly caused by viral infections (particularly enteroviruses). It can present with chest pain, shortness of breath, palpitations, and in severe cases, heart failure or sudden death.

Explore Individual Symptoms

In-depth pages for each symptom in this combination

Chest Pain — Full Overview Causes Treatment When to See a Doctor Related Questions

Palpitations — Full Overview Causes Treatment When to See a Doctor Related Questions

Medical Questions About Chest Pain and Palpitations

Evidence-based answers from medical experts

Early Signs of Hypertension How to Manage Hypertension Early Signs of Anxiety Disorder How to Manage Anxiety Disorder Early Signs of Heart Attack (Myocardial Infarction)How to Manage Heart Attack (Myocardial Infarction)Early Signs of Heart Failure How to Manage Heart Failure

Clinical Matches — Authority Pages

Condition-level differential and comparison resources for this combination

⚠ Dangerous — Rule Out First:

Heart Attack (Myocardial Infarction)

Differential analyses:

🔬Heart Attack (Myocardial Infarction): differential →🔬Atrial Fibrillation: differential →🔬Myocarditis: differential →

Condition comparisons:

⇄Atrial Fibrillation vs Panic Disorder →⇄Heart Failure vs Pulmonary Hypertension →

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