Chest pain that comes and goes can be caused by something as common as acid reflux or a strained chest muscle. But intermittent discomfort can also occur with heart and lung conditions. The fact that the pain stops does not automatically mean the cause is harmless.
It can be confusing when chest pain disappears and then returns. It may happen after eating, during activity, while resting, during stress, or with no obvious trigger. Some causes are common and treatable, while others need prompt or emergency evaluation.
The pattern matters, including how long episodes last, what triggers them, which symptoms come with them, and what risk factors you have. Mayo Clinic notes that chest pain has many possible causes, and that the most dangerous ones involve the heart or lungs. This guide explains what an on-and-off pattern can mean and when it needs attention. For a broader overview, see our guide to the causes of chest pain.
When Chest Pain That Comes and Goes Is an Emergency
Start here, before reading about causes. Call 911 or your local emergency number if chest pain comes with any of the following:
- Shortness of breath
- Cold sweating
- Nausea or vomiting
- Fainting or near-fainting
- Severe dizziness or lightheadedness
- Pressure, squeezing, heaviness, or tightness
- Pain spreading to the arm, shoulder, back, neck, or jaw
- Sudden, severe chest pain
- Sudden, severe breathing difficulty
- A racing or irregular heartbeat
Mayo Clinic recommends emergency help for sudden, severe, or unexplained chest pain lasting more than a few minutes, especially with breathing difficulty, fainting, or other concerning symptoms. Do not drive yourself.
Why you should not wait for it to become constant
Heart attack symptoms can sometimes ease and then return. They also vary a great deal between people and can be mild, according to Mayo Clinic. Do not wait for chest pain to become constant before seeking emergency care. You can read more about warning signs in our guide to heart attack symptoms.
Why Does Chest Pain Come and Go?
Intermittent chest pain happens when a trigger or process comes and goes, such as movement, a meal, stress, or reduced blood flow to the heart. Timing can offer clues about the cause.
| Pattern | Possible clue |
|---|---|
| After eating | Acid reflux or other digestive causes |
| During exercise | Possible heart-related cause or muscle strain |
| With movement | Musculoskeletal cause |
| With deep breathing | Lung or chest wall causes |
| During stress | Anxiety or panic may contribute |
| While lying down | Reflux or certain inflammatory causes |
| Random or recurrent | Several possibilities; evaluation may be needed |
These patterns are clues, not diagnostic tests. Symptom characteristics alone cannot reliably identify the cause, and one person can have more than one cause.
7 Common Causes of Chest Pain That Comes and Goes
1. Angina and Other Heart-Related Causes
Angina occurs when the heart muscle does not get enough blood flow. It may feel like pressure, tightness, squeezing, heaviness, or general discomfort in the chest. It can happen during physical activity or emotional stress, and it may improve with rest.
Because angina comes and goes, it is easy to dismiss. Heart-related chest pain may also spread to the arm, shoulder, back, neck, jaw, or upper abdomen.
Do not try to decide on your own whether your symptoms fit a “stable” pattern. New, worsening, more frequent, or unpredictable chest discomfort needs prompt medical assessment. Recurrent symptoms of any kind should be evaluated by a clinician.
Risk factors include high blood pressure, high cholesterol, diabetes, smoking, and family history. To learn more, see our guides on heart disease, high blood pressure, and high cholesterol.
2. Acid Reflux and Heartburn
Acid reflux can cause recurring chest discomfort. Typical features include:
- Burning behind the breastbone
- Symptoms after meals
- A sour taste in the mouth
- Regurgitation
- Symptoms when lying down
- Repeated episodes over days or weeks
Mayo Clinic notes that heartburn can feel like chest pain from a heart problem. Burning chest discomfort can occur with acid reflux, but the sensation alone cannot reliably tell reflux from a heart problem.
For more on reflux, see our guides to early signs of acid reflux, acid reflux risk factors, and acid reflux symptoms in older adults.
3. Muscle Strain and Chest Wall Pain
Chest wall pain can come from the muscles, ribs, and joints of the chest. Common triggers include:
- Exercise or weight lifting
- Repetitive movement
- Persistent coughing
- Minor injury
- Irritation of the chest wall
Clues may include pain that changes with movement, pain in one spot, or tenderness when you touch the area. Because the pain shifts with position, it often seems to come and go.
However, pain that changes with movement does not on its own rule out serious causes. Someone can have a muscle problem and a heart problem at the same time. If the pain is new or unexplained, have it checked.
4. Costochondritis
Costochondritis is inflammation of the cartilage that connects the ribs to the breastbone. It causes localized chest discomfort, often with tenderness near the breastbone.
Pain may get worse with movement, coughing, or deep breathing, and it may ease at other times. This is why costochondritis chest pain often comes and goes. Because it can feel alarming and can resemble cardiac pain, a clinician usually needs to rule out other causes before making the diagnosis.
5. Anxiety and Panic Attacks
Anxiety can produce real physical symptoms. According to Mayo Clinic, a panic attack can cause:
- Chest tightness or discomfort
- A rapid heartbeat
- Rapid breathing
- Sweating
- Dizziness
- Tingling
- A sense of fear or impending danger
Episodes often peak and fade within minutes, which fits an on-and-off pattern. Still, anxiety can cause chest symptoms, but new or unexplained chest pain should not automatically be attributed to anxiety. Do not assume anxiety is the cause just because you feel stressed. Learn more in our guides to what anxiety is and panic attacks.
6. Lung and Breathing-Related Causes
Several lung conditions can cause chest pain, including pleurisy, pneumonia, pulmonary embolism, and pneumothorax (collapsed lung).
Possible clues include:
- Pain when taking a deep breath
- Pain when coughing
- Shortness of breath
- Fever
- Sudden breathing difficulty
Mayo Clinic identifies serious lung conditions among the potentially life-threatening causes of chest pain. Sudden chest pain with significant shortness of breath requires urgent medical evaluation. See our guide to shortness of breath.
7. Other Digestive or Nerve-Related Causes
Other conditions can also cause recurring chest pain:
- Esophageal spasm or irritation: may cause squeezing pain or trouble swallowing
- Gallbladder problems: may cause upper abdominal pain that sometimes spreads toward the chest, often after meals
- Stomach-related conditions: such as ulcers, which can cause burning pain in the upper abdomen
- Shingles: often begins with burning or tingling pain on one side before a rash appears, according to the CDC
- Nerve-related pain: from irritated nerves in the chest wall or spine
For related reading, see common digestive problems.
Chest Pain That Comes and Goes by Situation
After eating
Reflux, heartburn, esophageal irritation, and other digestive problems are common reasons for chest pain that comes and goes after meals. Still, heart-related pain can show up after eating too, so do not assume it is only digestion. See our full guide on chest pain after eating.
During exercise
Chest discomfort that comes on during exertion deserves particular attention. It can be related to the heart, but muscle strain is also possible. Do not assume that stopping exercise and feeling better proves what the cause is. This pattern needs a medical evaluation, especially if it is new or keeps happening. Our guide on exercise and heart health explains why activity still matters once you have been evaluated.
When breathing
Pain with breathing can come from pleurisy, pneumonia, a pulmonary embolism, or the chest wall. Sudden pain with trouble breathing needs urgent care.
At rest
Chest pain at rest can have many causes and should not automatically be treated as less serious. Heart-related pain can occur at rest, as can reflux and anxiety. See also chest pain at night.
For days or weeks
Repeated chest pain over days or weeks deserves evaluation. Be especially careful if:
- Episodes are becoming more frequent
- The pain is getting stronger
- New symptoms develop
- It occurs with physical activity
- You have cardiovascular risk factors
How Long Does Intermittent Chest Pain Last?
People often look for a “safe” duration. There isn’t one.
- Seconds: Brief sensations may occur with muscle or nerve irritation, chest wall discomfort, or certain breathing-related sensations.
- Minutes: Episodes lasting minutes may occur with angina, reflux, panic symptoms, or musculoskeletal pain.
- Longer episodes: These may be associated with inflammation, digestive conditions, lung conditions, or heart conditions.
Duration alone cannot show whether chest pain is dangerous. A short episode can still matter, and a long one is not always serious.
When Should You Worry About Chest Pain That Comes and Goes?
More concerning patterns include:
- New chest pain
- Increasing frequency
- Increasing severity
- Pain during physical activity
- A pressure or squeezing sensation
- Pain spreading beyond the chest
- Shortness of breath, sweating, nausea, dizziness, or fainting
- Known heart disease
- Major cardiovascular risk factors
Intermittent does not mean harmless. Medical assessment is recommended for recurring or unexplained chest pain, even when it resolves quickly. For the full picture, see our guide to how to prevent heart disease and what heart health involves.
How Do Doctors Diagnose Recurring Chest Pain?
Doctors begin by looking for dangerous causes first, then work toward the most likely explanation. The 2021 AHA/ACC chest pain guideline emphasizes early identification or exclusion of life-threatening causes.
Medical history
A clinician may ask:
- When does the pain start?
- How long does each episode last?
- What were you doing when it started?
- Does exercise, eating, breathing, or movement affect it?
- Does it spread?
- What other symptoms happen with it?
Physical examination
Checks may include blood pressure, heart rate, oxygen saturation, and listening to the heart and lungs. A clinician may also examine the chest wall.
Possible tests
Depending on the suspected cause, tests may include:
- ECG or EKG
- Blood tests, including cardiac troponin
- Chest X-ray
- Echocardiogram
- Stress testing
- CT imaging
Testing is individualized, and not everyone needs every test. MedlinePlus has a helpful overview.
What Should You Do If the Pain Stops?
When the pain stops, it is tempting to move on. Here is how to think about it.
- If it was severe or came with emergency symptoms: Seek emergency care even if it has stopped.
- If it was new and unexplained: Arrange a medical evaluation.
- If it keeps recurring: Track the pattern and discuss it with a healthcare professional.
What to record
Writing down details can help your clinician. Note:
- The time of each episode and how long it lasted
- Where you felt it and what it felt like
- What you were doing at the time
- What you ate beforehand
- Whether breathing or movement changed it
- Any other symptoms
- What made it better or worse
Frequently Asked Questions About Chest Pain That Comes and Goes
Is chest pain that comes and goes serious?
It can be, but it is not always. Causes range from reflux and muscle strain to heart and lung conditions. Because you cannot tell which from the pattern alone, recurring or unexplained chest pain should be evaluated.
Can heart problems cause chest pain that comes and goes?
Yes. Angina often comes and goes, appearing with exertion or stress and easing with rest. New, worsening, or unpredictable symptoms need prompt medical assessment. See Mayo Clinic on angina.
Can acid reflux cause chest pain that comes and goes?
Yes. Reflux often causes repeated episodes of burning chest discomfort, especially after meals or when lying down. Because reflux can feel like heart pain, do not assume it is the cause of new chest pain.
Can anxiety cause intermittent chest pain?
Yes. Anxiety and panic can cause chest tightness, rapid heartbeat, and shortness of breath that come in episodes. New or unexplained chest pain should still be checked before it is attributed to anxiety.
Why does my chest hurt and then stop?
The pain may follow a trigger that comes and goes, such as a meal, movement, stress, or reduced blood flow to the heart. The fact that it stops does not prove the cause was harmless, so recurring episodes should be discussed with a clinician.
Why does my chest hurt after eating?
Reflux and indigestion are common causes. Gallbladder and heart conditions can also cause pain after meals. Read more in our guide to chest pain after eating.
Why does my chest hurt when I breathe?
Pain with breathing can come from the lining around the lungs, a lung infection, a blood clot in the lung, or the chest wall. If it comes with sudden shortness of breath, seek urgent care.
Can muscle strain cause chest pain that comes and goes?
Yes. Strained muscles or inflamed cartilage can cause pain that shifts with movement or pressure. Because the feeling can resemble heart pain, a clinician may need to rule out other causes.
Should I see a doctor if my chest pain keeps returning?
Yes. Recurring chest pain deserves a professional assessment rather than repeated self-diagnosis.
When should I call 911 for chest pain?
Call 911 for sudden, severe, or unexplained chest pain lasting more than a few minutes, or pain with shortness of breath, cold sweats, nausea, fainting, or spreading to the arm, back, neck, or jaw. See the American Heart Association warning signs.
Can chest pain disappear before a heart attack?
Yes. Heart attack symptoms can ease and then return, and some people have warning discomfort that comes and goes. This is why new or unexplained chest pain should not be ignored just because it went away.
What tests are used to find the cause of recurring chest pain?
Common tests include an ECG, blood tests such as troponin, and a chest X-ray. Others may include an echocardiogram, a stress test, or CT imaging. Your care team will choose tests based on your symptoms and risk factors.
Conclusion
Chest pain that comes and goes has many possible causes, including heart conditions, reflux, muscle and cartilage problems, anxiety, and lung or nerve conditions. The pattern offers clues, but it cannot tell you whether the cause is safe.
Intermittent does not mean harmless. If your chest pain is severe, comes with shortness of breath, sweating, nausea, or fainting, or spreads to your arm, back, neck, or jaw, call 911 right away. If it keeps coming back, schedule an evaluation instead of waiting for it to get worse.
Sources
- Mayo Clinic. Chest pain
- Mayo Clinic. Heart attack
- Mayo Clinic. Angina
- Mayo Clinic. Heartburn
- Mayo Clinic. Costochondritis
- Mayo Clinic. Panic attacks and panic disorder
- Mayo Clinic. Pleurisy
- MedlinePlus (NIH). Chest pain
- MedlinePlus (NIH). Pulmonary embolism
- MedlinePlus (NIH). Pneumothorax
- CDC. Shingles signs and symptoms
- American Heart Association. Warning signs of a heart attack
- Gulati M, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain. Circulation.
Medical Disclaimer: This article is for general information and education only. It is not medical advice, and it does not diagnose, treat, or prevent any condition. Chest pain that comes and goes can still be a sign of a serious or life-threatening problem. If you have sudden, severe, or unexplained chest pain, or you think you may be having a heart attack, call 911 or your local emergency number right away. For any health concern, talk with a qualified healthcare professional who can consider your personal history and needs. Never delay or ignore medical care because of something you read here.
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