Chest pain that wakes you up from sleep

The timing does not identify one cause. Burning behind the breastbone, sour fluid or discomfort after lying down can occur with Acid Reflux. Pressure, tightness or heaviness may be linked with Angina, while sharp pain with fever or cough can accompany Pneumonia. A sudden sharp pain with breathlessness needs consideration of Pulmonary Embolism. A racing heartbeat, trembling and intense fear can occur during Panic Disorder. Gastritis or Peptic Ulcer may cause upper abdominal discomfort that feels close to the chest. Shingles can cause burning or sensitive skin before a rash appears.

Stop exertion and sit upright. Note when the pain began, where it is, whether it spreads, and whether breathing, movement, food or position changes it. Do not drive yourself if the pain is severe, persistent or accompanied by weakness or breathlessness. If it has settled but keeps interrupting sleep, arrange a prompt clinical assessment and bring a list of medicines, including pain relievers and indigestion treatments.

Call emergency services immediately for chest pressure or pain that does not settle, or for pain with shortness of breath, sweating, faintness, confusion, blue lips, or pain spreading to the arm, back, neck or jaw. Seek urgent help as well for coughing blood, a very fast or irregular heartbeat, or sudden one-sided leg swelling with breathing difficulty. Do not wait for a morning appointment when these warning signs are present.

Could the pain be related to my heart, lungs, digestion or chest wall? Which examination or tests fit the pattern? Should I change any medicine taken at night? What symptoms should prompt emergency help if the pain returns?