Chest Pain During — Chemotherapy
Chest pain during chemotherapy is always a medical emergency. It can signal a heart problem, a blood clot in the lung, or a reaction to your drugs — and none of those can be ruled out at home.
Medically reviewed by Dr. Owais Mohammed, Medical Oncologist · Last reviewed September 2026
- Treat it as cardiac until proved otherwise — Your oncology team and the emergency department cannot tell the cause from symptoms alone. Tests are needed.
- Blood clots are a real risk on chemotherapy — Cancer treatment increases the chance of clots forming, including in the lungs, where they cause chest pain and breathlessness.
- Some drugs directly affect the heart — Certain chemotherapy drugs are associated with effects on the heart muscle or the arteries that supply it.
- Do not wait to see if it passes — Every serious cause of chest pain is better treated sooner. Waiting reduces what can be done.
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Chest pain during chemotherapy is always a medical emergency until your team has ruled out a serious cause. It can signal a heart problem, a blood clot in the lung, or a drug reaction. Go to the nearest emergency department now — do not wait to see if it improves.
If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.
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Not sure whether this counts as an emergency?
Call the helpline. It is always better to check than to wait.
What to do right now
- Go to the nearest emergency department immediately. Do not wait.
- Do not drive yourself — call someone to take you, or call emergency services.
- Tell the triage nurse you are on chemotherapy and name your drugs if you can.
- Bring your chemotherapy card or drug list — the ER team will need it.
- Call your oncology team's emergency number on the way so they can guide the ER team.
- Do not take a painkiller and stay home to see if the pain settles.
What could your chest pain mean?
| What you feel | What this could be |
|---|---|
| Squeezing or crushing pressure in the chest | Heart muscle affected by chemotherapy |
| Sharp pain that worsens when you breathe in | Blood clot in the lung, or inflamed lining around the lung |
| Pain spreading to the arm, jaw or shoulder | Heart attack |
| Chest pain with a swollen, painful leg | Blood clot that may have moved from the leg to the lung |
| Chest pain with fever and cough | Chest infection or inflammation around the heart |
| Typically starts | During an infusion or any time from days to weeks after — timing varies by drug |
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Frequently asked questions
Does chest pain on chemotherapy always mean a heart attack?
No — but a heart attack cannot be ruled out without tests, which is why chest pain on chemotherapy must be treated as one until the emergency team says otherwise. Other causes include a blood clot in the lung, inflammation around the heart, a drug reaction, or a chest infection. All are serious, and none can be safely diagnosed at home. An ECG and blood tests will establish what is happening.
Can I take a painkiller and rest to see if the pain goes away?
No. Taking a painkiller can reduce the pain while the underlying cause continues, creating false reassurance and delaying treatment that could help. If the pain settles quickly on its own, you still need to call your oncology team today — it does not mean nothing happened, and some causes can recur or worsen without warning.
Which chemotherapy drugs are most likely to cause chest pain?
Anthracyclines such as doxorubicin and epirubicin are associated with effects on the heart muscle. Fluorouracil and capecitabine are associated with coronary artery spasm, which produces pain similar to a heart attack. Some targeted therapies also carry cardiac risks. Your oncologist will have assessed your cardiac history before prescribing these drugs. The point is the same regardless of which drug you are on: chest pain needs emergency assessment.
What will happen at the emergency department?
Tell the triage nurse immediately that you are on chemotherapy — this prioritises your care. You will have an ECG, blood tests including a troponin level to check for heart injury, and a pulse oximeter reading. Depending on the results, a chest X-ray or CT scan may follow. Having your drug list with you helps the team decide which tests matter most for your specific treatment.
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