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21 Reasons You Have Random Chest Pain

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Written by Carina Ryder, MS, BSN.
Certified Nurse Midwife, Takoma Park Gynecology
Last updated May 24, 2024

Chest pain quiz

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While chest pain can be very scary, it often is not as serious as it may seem. Pain on the left, right, or middle of the chest can be from an anxiety or panic attack disorder, heartburn or gastric distress, GERD, IBS, and many other conditions.

21 most common cause(s)

Pulmonary Embolism
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Acute Costochondritis
Stomach Ulcer
Lung Abscess
Atrial Fibrillation
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Heart Attack
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Angina pectoris
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Aortic Dissection
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A hiatal hernia
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Hypertrophic cardiomyopathy
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Rib bruise
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Rib fracture

Chest pain quiz

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What’s causing pain on the left or right side of my chest?

Chest pain can be very frightening. But there are many conditions besides a heart attack that can cause chest pain on the right or left side, including those related to the lungs, muscles, and digestion.

When sudden chest pain comes out of nowhere, and you haven’t had a big meal or experienced a physical or mental trauma, do not wait to get help. Especially if the pain is sudden, sharp, recurring and fading, or is accompanied by numbing of the limbs. And if you are not sure what is causing your pain, go to the ER or call 911.

Chest pain left side vs right side

People often think chest pain on the left side is a sign of a heart attack because that is where the heart is located. But pain on the left side of the chest doesn’t always mean it’s a heart issue. And pain on the right side shouldn’t be ignored. Heart attacks can cause pain all over the body—from the left side of the chest, to the right side of the chest, and even in other areas like the shoulder or jaw. It can also be different in men and women.

Being able to describe the location of the pain—like upper chest pain, left side chest pain, or right side chest pain—can help with diagnosing the cause of your chest pain and getting the right treatment sooner.

While chest pain that is only on the right side of the chest is less likely to be a heart issue, it doesn’t mean that right side chest pain isn’t serious. There can be many reasons for chest pains on the right side, including

  • Pneumonia
  • Bruised or broken rib
  • Torn chest muscle
  • Viral infection
  • Gallbladder, liver, pancreas, spleen, or lung issues
  • Pleuritic pain (inflammation around the lung)
  • Blood clot in the lung
  • Digestive condition like IBS, GERD, or heartburn

Common causes of chest pain

1. Acid reflux, GERD, and heartburn

Acid reflux, heartburn, or GERD can feel like a burning sensation in the chest and behind the breastbone. The sensation can move up and down the throat and there is often a feeling of burning acid in the throat. It often happens after eating, especially if you have large meals, drink alcohol or smoke during or after the meal, and lie down too soon after eating.

Many people confuse this sensation with having a heart attack, as it can be uncomfortable and cause pain in the middle of the chest.

2. Angina pectoris (coronary artery disease)

Angina, also called coronary artery disease and heart disease, is a condition that develops from plaque buildup in the arteries. Chest pain from angina pectoris is because of poor blood flow to the heart. Symptoms are often mistaken for heartburn or indigestion.

Symptoms include a feeling of heaviness in the chest area, numbness, burning, aching, and pain in the chest. Discomfort is usually felt mostly in the chest area, but it is also common in the left shoulder or arm, neck, or back. Other symptoms are nausea, sweating, tightness in the chest, and pain in the left arm or jaw.

3. Anxiety

Anxiety often causes pain and discomfort in the chest as well as a speeding up of the heartbeat. Nearly 25% of patients who report chest pain to their doctors are diagnosed with a panic disorder, which can cause pain in the middle of the chest area and a feeling that can seem like having a heart attack.

But any chest discomfort shouldn’t be ignored, as patients with panic disorder and chest pain have higher rates of cardiovascular disease. Whenever you have chest pain—especially for people with anxiety disorder—go to the ER to make sure it isn’t something more serious.

4. Aortic dissection

An aortic dissection is when the large blood vessel coming off from the heart tears. As blood rushes through the tear, other layers of heart tissue can begin to separate. The pain is sudden and feels like a tearing sensation.

You may feel it on the left side, be dizzy, and have trouble speaking and seeing. If the blood ruptures through the aortic wall, it can be fatal. Get immediate medical care.

Symptoms of an aortic dissection include chest pain that is severe enough to knock the wind out of you. The pain radiates down the back and is so intense that fainting is common.

5. Asthma

For most people with asthma, symptoms are mild and manageable. But often, especially when aggravated by allergies, an asthma attack can be serious, causing chest tightness along with wheezing, shortness of breath, and coughing.

Anyone who has asthma should carry an over-the-counter inhaler with them at all times. If you are having an asthma attack and have chest pain, get medical attention immediately and use your inhalers as directed by your doctor.

6. Atrial fibrillation

Atrial fibrillation is a rapid and irregular heart rate when the heart’s upper chambers beat out of sync with the lower chambers of the heart. The fast, pulsing heartbeat can sometimes cause chest pain. Atrial fibrillation does not always cause symptoms. Sometimes it is discovered during a routine physical exam.

Symptoms of atrial fibrillation, also called A-fib, include feelings of lethargy, overall weakness, heart palpitations, dizziness, confusion, difficulty breathing, and sometimes chest pain. A-fib increases your risk for a stroke and problems with the heart.

7. Bronchitis

While chest pain from bronchitis is usually mild, coughing can worsen the pain.

The symptoms of bronchitis include a dry, hacking cough, fatigue, and yellowish, whitish, or greenish mucus that may be streaked with blood. Bronchitis can also cause shortness of breath, fever, and a feeling of tightness in the chest.

8. Costochondritis

Sometimes chest pain is caused by costochondritis—inflammation around the ribs. It is a fairly common cause of chest pain and is often felt in the middle of the chest.

Costochondritis can be caused by daily activities, like accidents or falls, coughing a lot, vomiting, pulled muscle in the chest during strenuous exercises or sports activities, a car accident (can be from the air bag inflating), and some types of arthritis or bursitis.

The main symptom of costochondritis is a sharp pain in the chest wall and ribs that comes and goes. Heavy breathing can intensify the pain, along with coughing or sneezing.

9. Heart attack

When blood flow to part of the heart is cut off,  usually from a plaque rupture in a coronary artery, it can cause varying amounts of chest pain, especially on the left side. You may also have shortness of breath, nausea, sweating, and not feeling well. Since the symptoms of a heart attack are not exactly the same for every person, even mild chest pain needs to be taken seriously.

If you have chest pain and have never had it before, especially with shortness of breath or pain radiating to your arm, back or jaw, assume you are having a heart attack and call 911.

10. Hiatal hernia

A hiatal hernia is when some of the stomach pushes through an opening of the diaphragm, which is a muscle that separates the abdomen from the chest.

Symptoms are usually mild, but after eating you may have pain in the chest, especially on the left side, along with heartburn, esophagus problems, regurgitation, or trouble swallowing.

The risk for a hiatal hernia increases with age and weight gain. A change in diet and eating smaller meals can help with pain and discomfort.

11. Hypertrophic cardiomyopathy

When part of the heart becomes thicker than the rest, the condition is called hypertrophic cardiomyopathy. The condition makes it harder for the heart to pump blood throughout the body.  Hypertrophic cardiomyopathy can develop suddenly in the heart tissue, so get medical attention if you faint after exercise or have unexplained symptoms.

It is usually inherited and can affect any age, but younger patients typically have more severe forms of the condition. Sometimes it is discovered when an athlete suddenly collapses and has a cardiac arrest.  

While some people with hypertrophic cardiomyopathy don’t have symptoms, others may experience dizziness, fainting during strenuous activities, chest pain while running or exercising, palpitations, and shortness of breath when waking up. Sometimes athletes are screened for it with an echocardiography.

12. Lung abscess

A lung abscess is a very rare condition, and is typically from a severe infection of the lungs like pneumonia or tuberculosis. There may be chest pain when breathing or coughing from inflammation of the lungs and chest wall.

Symptoms include a fever, loss of appetite, an overall sick feeling for several weeks or months, clubbing of the fingers, a bluish skin color, and chest pain.

13. Myocarditis

If the heart muscle becomes infected and inflamed, myocarditis could be the cause. Myocarditis is rare but can often lead to severe cardiac issues and some people may need a heart transplant. If you have flu symptoms with intense chest pain, get medical care right away.

The symptoms of myocarditis are similar to the flu, including fatigue, fever, joint pain, and muscle aches. Chest pain, rapid breathing, and fainting are some other symptoms of myocarditis. A chest X-ray may be needed to diagnose myocarditis.

14. Peptic ulcers

A peptic ulcer is a raw area or open sore in the stomach lining or at the beginning of the small intestine. When the stomach or intestines can’t protect themselves against strong stomach acids these ulcers can form.

The most common symptom of a peptic ulcer is abdominal or chest pain, along with mild nausea. Your pain may get better when eating food or taking antacids and heartburn. A gastroenterologist can do a test called an upper endoscopy to see if you have a peptic ulcer.

15. Pneumonia

Pneumonia is a respiratory condition. Bacteria, viruses, and fungi can cause an infection in the lung that develops into pneumonia. You may have sharp chest pain that is worse when coughing or taking a deep breath

The main symptom of pneumonia is a cough, which is often accompanied by a thick and yellow-colored mucus. You may also have a fever, and chills and shortness of breath. If someone is elderly, has a weak immune system, or has any serious medical conditions, get medical attention immediately. Pneumonia in the elderly can quickly become life-threatening

16. Pulled muscle

When a muscle is pulled, over-stressed, or torn in the chest area, there can be chest pain that can feel like it may be a heart attack.

Pulled muscles can be caused by improper form during exercise, strenuous weight lifting or cardiovascular exercise, swinging a bat, playing soccer, or suddenly moving the wrong way. Car crashes, falls, and other accidents can also cause pulled chest muscles.

If the pulled muscle is in the abdominal or back area,  you may have chest pain along with stiffness and bruising. You may feel it when doing movements like stretching.

17. Rib bruise

A bruised rib can cause chest pain that is severe. A bruised rib is usually from a direct blow to the chest, like during a car accident, fall, or playing sports.

Symptoms of a rib bruise include pain and tenderness near the injured rib along with chest pain that increases when you breathe deeply, move, cough, or sneeze.

18. Rib fracture

A fractured rib can be from an accident, like a fall or car crash. Intense coughing can also fracture a rib, as can repetitive movements or overly intense exercise. Chest pain that is constant and gets worse when breathing or moving could be a sign of a rib fracture.

Like other rib injuries, symptoms of a rib fracture include discomfort when breathing deeply, pain while bending or twisting, or a feeling of pressure in the chest or rib area.

19. Shingles

Shingles is from the same virus that causes chickenpox. If you’ve ever had chickenpox, then you can get shingles.

One of the earliest signs of shingles can be intense chest and back pain, followed by a painful, blistering rash. The pain may be sharp, burning, and feel like the heart is hurting.

Shingles can be very painful if it’s not treated quickly.  If you think you have shingles, call your doctor or go to the ER.

20. Pneumothorax (collapsed lung)

Pneumothorax is the medical term for a collapsed lung. When the lung collapses, it cannot expand as you try to breathe. It makes it hard to breathe, along with severe chest and lung pain. It is usually very painful.

A collapsed lung can happen suddenly and without warning. It can be from an injury (like a fractured rib) or or an illness, like pneumonia. Symptoms can be mild or severe with intense pain.

21. Pulmonary embolism

A pulmonary embolism is when blood flow to the lungs through the pulmonary artery is blocked. It is usually from a blood clot in the legs or pelvis that travels to the lungs. You may have intense chest pain, especially when trying to breathe.

If you feel short of breath, are experiencing intense chest pain that worsens when you breathe deeply, move, or cough, and have a cough with pink, foamy mucus, get immediate medical care.

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Right chest painPosted January 14, 2022 by F.
I use to feel chest pain on my side in such that I can not lift or rise my arm up and if that happens my vetebrate will begin to be hot like fire
Dr. Peter Steinberg is a board-certified urologist and the director of endourology and kidney stone management at Beth Israel Deaconess Medical Center. He is also an Assistant Professor at Harvard Medical School. He received his undergraduate degree in biochemistry from Middlebury College (1999) and graduated from University of Pennsylvania Medical School (2003). He completed a urology residency a...
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