Chest Pain: When to Worry and When to Call 112
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Chest pain: when to worry and call 112, how to tell anxiety from the heart, and the common harmless causes. Clear red flags from NHS and ESC guidance.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Chest pain is a reason to worry, and to call 112 now, when it is sudden and does not go away, spreads to an arm, the neck, jaw, stomach or back, or comes with sweating, sickness, light-headedness or breathlessness. Most chest pain is not from the heart. It is often a strained muscle, reflux or anxiety. But you cannot be sure at home.
- Call 112 for chest pain that is sudden and lasting, feels tight or crushing, spreads, or comes with sweating, sickness, dizziness or breathlessness.
- European heart experts (ESC) say to call for help, day or night, when chest pain lasts more than 15 minutes or comes back within an hour.
- Do not drive yourself to hospital. Wait for the ambulance.
- Most chest pain is not your heart. Common causes are muscle strain, reflux, anxiety and chest infections.
- Anxiety can cause real chest tightness. Treat a first episode as a possible heart problem until a doctor has checked you.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
When should you worry about chest pain?
Call 112 straight away if you have any of these. They come from NHS and MedlinePlus advice:
- Sudden pain or discomfort in the chest that does not go away.
- Pain that spreads to your left or right arm, or to your neck, jaw, stomach or back.
- Chest pain with sweating, feeling sick, feeling light-headed or being short of breath.
- Chest pain that feels tight, heavy or squeezing.
- Severe trouble breathing, such as gasping or not being able to get words out.
- Pale, grey or blue lips or skin, or someone who has collapsed and is not responding normally.
- Sudden, sharp pain with breathlessness after a long trip or bed rest, or with one leg more swollen. This can be a clot in the lung.
- Sudden, severe pain in the chest and upper back. This can be a tear in the main artery.
- Known angina that gets stronger, comes on with less effort or starts at rest.
Do not wait to see if it passes. The European Society of Cardiology (ESC) tells the public to call emergency services, day or night, when chest pain lasts more than 15 minutes or comes back within an hour.
In Spain the number is 112, the same job as 999 in the UK or 911 in the US. The hospital emergency department is urgencias.
What should you do while you wait for the ambulance?
- Stop and rest, sitting with your back supported.
- Do not drive yourself to hospital.
- Aspirin only if told. Mayo Clinic says not to take aspirin unless the emergency team tells you to. Never delay the call to look for it. Do not take it if you are allergic.
- If the person stops responding and is not breathing normally, start CPR. The 112 operator will guide you.
Is it my heart? Signs that point to the heart
Heart pain from angina or a heart attack is often described as pressure, tightness or squeezing. It may spread to the arm, shoulder, jaw or back. It can come with sweating, sickness, breathlessness or dizziness.
Mayo Clinic notes that women, older adults and people with diabetes may have milder signs. Nausea or a brief neck or back pain may be the only clue. Heart symptoms can also feel like indigestion.
Risk is higher with smoking, extra weight, high blood pressure, diabetes, high cholesterol, or a close relative who had an early heart attack (before 55 in men or 65 in women, says Mayo Clinic).
Chest tightness: is it anxiety or my heart?
Anxiety and panic attacks can cause real chest pain or tightness, with a racing heart, sweating, fast breathing and fear. Many of these signs also happen in a heart attack. So the feeling alone cannot tell you the cause.
Some patterns point more towards anxiety:
- It starts at a time of stress or fear, often with fast breathing.
- It comes with tingling in the hands or around the mouth.
- It builds, peaks and settles as your breathing slows.
- It has happened before, and a doctor has checked your heart.
Some patterns point more towards the heart: pain that comes on with effort and eases with rest, pressure that spreads to the arm or jaw, or pain with sweating and feeling sick.
The safe rule: if it is the first time, if it feels different from your usual anxiety, or if you are in doubt, call 112. Once the heart is ruled out, panic attacks can be treated with talking therapy and, for some people, medicine.
Chest tightness that keeps coming back with stress or worry, and a doctor has already ruled out your heart?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He goes through your symptoms and history and helps you plan the next steps for anxiety.
What are the common harmless causes of chest pain?
The NHS says most chest pain is not caused by the heart. Common causes include:
- Muscle or rib strain, after exercise, lifting or coughing.
- Costochondritis. Inflamed cartilage where the ribs join the breastbone. The spot is tender to touch.
- Reflux or indigestion. A burning feeling behind the breastbone, often after meals or when lying down. See our guide on omeprazole in Spain.
- Chest infection or pleurisy. Sharp pain when you breathe in or cough, often with a fever or coloured phlegm.
- Shingles. Burning or tingling on one side, then a band of blisters.
MedlinePlus notes that pleurisy and pneumonia cause sharp pain that gets worse with deep breaths or coughing. Pain you can bring on by pressing the spot often comes from muscles or ribs. Still, these clues are not proof.
When should you see a doctor today?
If there are no 112 signs, see a doctor today, without waiting, if:
- Chest pain comes and goes, even if it is mild.
- The pain went away quickly but you are still worried.
- You have a fever or a cough with yellow-green phlegm.
- You have trouble swallowing.
- Chest pain has lasted more than 3 to 5 days.
A video visit cannot do an ECG: go to your centro de salud or urgencias. MedlinePlus notes that, in children, most chest pain is not caused by the heart. A child with chest pain and breathlessness, fainting or a blue tinge still needs 112.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask what the pain feels like and what changes it.
- Check for red flags and send you to urgencias or 112 if anything points to the heart, lungs or a major artery.
- For pain already checked in person, look at muscle, reflux or anxiety causes and agree a plan.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace a consultation with your doctor or an emergency assessment.
Frequently asked questions
When should I worry about chest pain?
Call 112 for chest pain that is sudden and does not go away, feels tight or crushing, spreads to the arm, neck, jaw, stomach or back, or comes with sweating, sickness, dizziness or breathlessness. ESC guidance also says to call when chest pain lasts more than 15 minutes or returns within an hour.
How can I tell if chest tightness is anxiety or my heart?
You cannot be sure at home. Anxiety often comes with fast breathing, tingling and fear, and settles as you calm down. Heart pain is often pressure that spreads or comes with effort. Treat a first or different episode as a possible heart problem and call 112.
Can a heart attack feel like indigestion?
Yes. The NHS lists a burning chest or a full, bloated feeling as possible heart attack symptoms. Do not assume it is indigestion if it comes with other warning signs.
Should I take aspirin for chest pain?
Only if the emergency team tells you to, and never if you are allergic. Call 112 first and do not delay the call to look for aspirin.
Can a video doctor check chest pain?
Not new or severe chest pain: that needs 112 or urgencias, an ECG and sometimes blood tests. A video visit can help with pain already checked in person, such as muscle pain, reflux or anxiety.
Sources
- NHS: Chest pain
- NHS: Heart attack symptoms
- European Society of Cardiology: Guidelines on acute coronary syndromes
- MedlinePlus: Chest pain
- Mayo Clinic: Heart attack, symptoms and causes
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
