Understanding Chest Pain Symptoms and Diagnosis: A Quick Guide for Malaysians

Experiencing chest pain may indicate serious underlying health conditions. While some cases of chest pain symptoms are mild and temporary, others could signal critical medical emergencies like heart attacks. This article explores chest pain causes, associated symptoms, and potential treatments, helping individuals understand when to seek medical attention in Malaysia — especially from a qualified cardiologist.

Common Causes of Chest Pain

There are various causes of chest pain, ranging from minor muscle strain to life-threatening conditions:

1. Cardiac-Related Causes

  • Heart attack – A blockage in the coronary artery reduces blood flow to the heart, causing severe chest discomfort.
  • Angina – Narrowed arteries restrict oxygen supply, resulting in chest pain symptoms during physical activity, and sometimes at rest too
  • Pericarditis – Inflammation of the heart’s outer lining leads to sharp chest pain that worsens while lying down.
  • Myocarditis – Heart muscle inflammation can mimic the symptoms of a heart attack.

2. Gastrointestinal Causes

  • Acid reflux (GERD) – Stomach acid travelling back into the esophagus triggers burning chest pain symptoms, often mistaken for a heart issue.
  • Esophageal spasms – Sudden contractions in the esophagus can cause intense, squeezing chest pain radiating to the back.
  • Gallbladder disease – Issues like gallstones may cause discomfort that radiates to the chest area.

3. Respiratory Causes

  • Pulmonary embolism – A blood clot in the lungs can lead to sharp chest pain and breathing difficulties.
  • Pleurisy – Inflammation of the lung lining causes chest pain symptoms when breathing deeply.
  • Pneumonia – A severe lung infection may result in chest pain, fever, and difficulty breathing.

4. Musculoskeletal Causes

  • Costochondritis – Inflammation of the rib cartilage causes localised chest pain upon movement or pressure.
  • Muscle strain – Overexertion or injury can result in temporary chest pain symptoms.

The most critical chest pain is a heart attack. Other life-threatening conditions include aortic dissection, pulmonary embolism, and tension pneumothorax. Seek immediate medical attention or consult a cardiologist to avoid the risk of permanent heart damage or even death. 

Chest pain can share similar symptoms but different treatments. For example, heart attack and angina, both related to reduced blood flow to the heart, can cause chest pain, but a heart attack requires immediate emergency treatment, while angina can often be managed with lifestyle changes and medications prescribed by a cardiologist. 

Chest Pain Symptoms You Shouldn’t Ignore

The nature of chest pain symptoms varies depending on the underlying condition. Some common indicators include:

  • Sharp or dull pain in the chest region
  • Pressure, tightness, or a squeezing sensation
  • Pain radiating to the arms, jaw, or back
  • Difficulty breathing
  • Heart palpitations
  • Dizziness or nausea

Severe chest pain symptoms that are accompanied by sweating, fainting, or confusion should never be ignored. In such cases, seeing a cardiologist promptly can make a life-saving difference.

How Chest Pain Is Diagnosed: What to Expect During Your Visit to a Cardiologist

Since chest pain causes vary from mild muscle strain to serious heart conditions, our doctors and cardiologists at Bukit Tinggi Medical Centre (BTMC) use multiple diagnostic methods to ensure accurate assessment, including:

1. Medical History and Physical Examination

The first step in diagnosing chest pain symptoms involves discussing medical history and conducting a physical examination.

2. Electrocardiogram (ECG/EKG)

An ECG records the heart’s electrical activity and helps detect irregular rhythms, heart attacks, or conditions linked to chest pain causes.

3. Blood Tests

Blood samples are taken to check for heart-related markers, including troponin levels, which indicate heart damage after a heart attack.

4. Chest X-Ray

A chest X-ray helps visualise abnormalities such as lung infections, collapsed lungs, or heart enlargement—all potential chest pain causes.

5. Echocardiogram 

An echocardiogram uses ultrasound waves to examine heart structures, detecting issues like valve abnormalities or weakened heart muscle function.

6. Stress Test

A stress test evaluates heart performance during physical exertion and may indicate angina or coronary artery disease contributing to chest pain symptoms.

7. CT Coronary

A CT scan can help visualise blood vessels, detecting blockages or structural heart problems.

8. Coronary Angiography

This test uses contrast dye and X-rays to examine coronary arteries, identifying blockages that may require intervention like coronary artery bypass graft (CABG) surgery.

9. Pulmonary Function Tests

For suspected respiratory issues, lung function tests help assess conditions like asthma, pneumonia, or pulmonary embolism—all possible chest pain causes.

10. Cardiac MRI

This imaging test provides detailed views of the heart muscle, detecting disease in the myocardium, assessing heart function and muscle viability, and identifying valvular disorders that may contribute to chest pain. 

Your Heart Health Matters: Get Checked Before It’s Too Late

BTMC offers a comprehensive approach for accurate diagnosis. If you experience persistent chest pain, book a heart check or health screening with our doctors for timely evaluation and intervention.