Chest Pain During Exertion: Is It Dangerous?

Chest Pain During Exertion: Is It Dangerous?

Chest pain during exertion is a red flag alerting you to a potentially serious heart condition. While exercise-induced chest pain could be related to your chest muscles or lungs, it’s a classic symptom of a problem with your heart.

Seeking an evaluation from Laura Fernandes, MD, FACC, at Woodlands Heart and Vascular Institute is the only way to learn the cause of your chest pain. Then she can recommend the next step to protect your heart and prevent progressive damage.

Heart problems related to chest pain during exertion

Chest pain that begins when you’re active may be caused by the following conditions: coronary artery disease (CAD), hypertrophic cardiomyopathy, or a heart attack.

Coronary artery disease

CAD begins when cholesterol and other substances collect in the arteries carrying blood to your heart. The plaque keeps accumulating and, over time, gets large enough to restrict blood flow.

A partial blockage doesn’t cause symptoms when you’re relaxing or walking at a casual pace. These movements put minimal stress on your heart, which means the limited blood supply is enough to meet its needs.

 But your skeletal muscles need extra oxygen when you begin exercising or engaging in more strenuous movement. As a result, your heart automatically works harder to pump more blood to your body.

When your heart works harder, it also needs more oxygen — oxygen it can’t get because of the clogged coronary artery. The heart’s lack of oxygen causes chest pain during exertion, a condition called angina.

Angina may also cause the feeling of tightness or pressure in your chest, shortness of breath, fatigue, nausea, and back, arm, or neck pain. As CAD progresses and the blockage gets worse, you may have chest pain even when you’re resting.

Hypertrophic cardiomyopathy (HCM)

HCM occurs when the muscular wall in the heart’s lower left chamber (ventricle) thickens. When the muscles get thick and stiff, they can’t work properly and your heart can’t send enough blood out to your body.

You may not have symptoms, but if they appear, you experience chest pain and shortness of breath when exercising. You may also faint during or after you exercise. HCM can also cause a rapid heart rate or a fluttering sensation in your chest. 

Heart attack

Chest pain when you exercise is extremely dangerous if it signals a heart attack. Heart attacks occur when a blocked coronary artery severely limits or stops blood flow to your heart.

Some heart attacks cause sudden, severe chest pain; others start with mild pain that gradually gets worse.

Chest pain that’s accompanied by one or more of the following symptoms has a high chance of being a heart attack:

Call 911 as soon as you suspect you’re having a heart attack.

Telltale signs associated with chest pain

A few telltale signs offer hints about whether your chest pain is caused by CAD or a heart attack:


Stop exercising as soon as the chest pain begins. Sit down, rest, and wait to see if the pain goes away.

You’ll feel better within five minutes if CAD is the cause, and if that happens, you don’t need emergency attention. 

Though you don’t need emergency care, it’s still essential to schedule an appointment for a heart evaluation. If we determine you have CAD, you can begin treatment to stop the blockage from getting worse (and prevent a heart attack).

Whether you have a history of angina or this is your first episode, call 911 if your chest pain is severe, doesn’t improve, or you have other heart attack symptoms.

Heart attack

Chest pain caused by a heart attack lasts longer than five minutes, and the pain usually intensifies as time passes.

Sharp, stabbing pain that disappears or pain that improves when you change positions typically signals a strained muscle rather than a heart attack.

Though these hints point toward the cause of your chest pain, don’t try to second-guess the problem. Getting medical care and learning your chest pain was due to heartburn may be embarrassing, but finding the reason for the pain will save your life if you have a heart condition.

Call our office in The Woodlands, Texas, or use online booking if you have questions about chest pain or want to schedule an appointment.

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