Complaints & connections · borters.ch
Usually harmless and muscular — but with tightness, radiating pain or breathlessness every minute counts: 144.
Also known as: chest pain · chest pressure · chest tightness
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Chest pain has many — often harmless — causes: strained muscles or ribs, heartburn/reflux, stress and anxiety, or a respiratory infection. But beware: certain signs can come from the heart and are an emergency. Call emergency services immediately (144 in Switzerland) for strong pressure or tightness behind the breastbone radiating to the arm, neck, jaw or back — especially together with breathlessness, cold sweat, nausea or anxiety, and if it lasts more than a few minutes. When in doubt, it’s better to call once too often. Without such signs, if the pain depends on movement, pressing the spot or breathing, a harmless cause is more likely — but new or unclear chest pain should be assessed. A faint or a collapse shortly before or during the chest pain also counts on its own among the warning signs, whether or not the typical tightness is felt.
The key point: if a heart attack is suspected, don’t wait — call emergency services immediately.
Movement/pressure- or breathing-linked pain without warning signs is usually harmless.
Reflux measures or easing tension help the common harmless causes.
Even without an acute emergency, new or recurring chest pain should be assessed.
Chest pain that is worse lying down and better leaning forward — the heart attack has no such dependence on posture.
Of a hundred people coming to a practice with chest pain, about ten to fifteen have a heart cause; in the emergency department it is considerably more. Muscle, rib and oesophageal causes are the most common. What speaks for the heart is pressure or tightness under exertion that eases after a few minutes of rest; what speaks against it is pain that can be reproduced by pressing on the spot.
Nitroglycerin under the tongue widens the vessels within one to three minutes — but the fact that it helps proves nothing, because it also works in oesophageal spasm. Conversely, an acid blocker that helps does not rule out a heart problem. So with acute suspicion, measurements come first rather than trials. Aspirin with suspected heart attack is chewed, because it works faster that way. For muscle and rib causes, anti-inflammatory gels work locally.
Pressure/tightness, radiation to arm/jaw, breathlessness, cold sweat → call 144 now.
Pain triggered by movement or pressing is more likely from muscle/rib.
Points more to reflux (rising stomach acid).
Breathing-linked pain can come from the pleura or airways.
They lower the blood fats and act on the excitability of the heart muscle. Oily sea fish twice a week is the best-supported route; very high doses from capsules are not a harmless more.
Keeps the rhythm steady and lowers blood pressure. Water tablets drive it down, certain blood pressure drugs and a weak kidney drive it up — which is why it is checked under treatment.
A lack favours extra beats and at the same time keeps a potassium deficiency going. Anyone replacing only the potassium sees no success while the magnesium is missing.
Less salt lowers blood pressure measurably, and most of it is not in the salt cellar but in bread, cheese, cured meat and ready meals. With very low blood pressure the opposite applies.
With chest pain not a single supplement stands before the placing of it — pressure or tightness, with radiating pain, with breathlessness or cold sweat is a question of minutes. What stabs with breathing, can be brought on with a finger or burns on bending may be looked at calmly.
With extra beats and the feeling of a stumbling heart magnesium helps if a deficiency is present — and only then. It is one of the few complaints that can be checked on oneself within weeks; the laboratory value decides nonetheless, because too much is not harmless with weak kidney performance.
A large part of the chest pains that do not come from the heart come from the gullet — and there coffee, alcohol, late large meals and peppermint are the classic amplifiers. Peppermint oil relaxes the closing muscle and is therefore in reflux of all things unfavourable, although it helps against abdominal cramps.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
Broken heart syndrome mostly affects women after menopause, usually after a sudden strain. On the ECG and in the blood it looks like a heart attack, but the coronary arteries are open — and it mostly heals completely.
In women a heart attack more often shows without the typical pressure behind the breastbone — nausea, back pain, breathlessness and exhaustion take its place. That is one of the reasons it is recognised later in women.
Reflux from the stomach causes chest pain that is confusingly like heart pain — and the other way round. That it comes after eating does not rule out the heart; that is the point where the wrong turn is most often taken.
Burning behind the breastbone after eating or when lying down often comes from the oesophagus. But no one decides that themselves — with new chest pain the heart is checked first.
With chest pain from tension or hyperventilation slow breathing helps within minutes. But no one may decide that themselves — with new chest pain the heart is assessed first.
AWMF 053-023 · S3 · 2025-07 — in force
Brustschmerz — DEGAM-Leitlinie für die primärärztliche Versorgung
checked 2026-09