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Chest pain can be caused by more than just heart attacks. Read the top 10 causes for right/left sided chest pain and how to know when chest pain is serious.
Chest pain symptoms
Chest pain is tricky, as it could be as serious as a heart attack or as harmless as an episode of heartburn. Your chest is home to your heart, lungs, and esophagus — all protected by your ribs and the muscles between them. A problem in any of these can lead to chest pain. Your immediate thought may be "heart attack," regardless of the amount of spicy food you ate; however, a heart attack is one of the least common causes of chest pain. Most chest pain is due to stomach, lung, or musculoskeletal problems.
Common characteristics of chest pain
If you are experiencing chest pain, the following characteristics are likely.
- Tearing or ripping sensation
Common accompanying symptoms
Chest pain might be accompanied by the following.
- Feeling like you might faint
Depending on the cause, chest pain may get better with rest and worse with activity. It can also be exacerbated in cold environments or by emotional stress. It might hurt differently when you inhale than when you exhale — this all depends on what's causing the pain, making it important to see a physician immediately if it worsens or persists.
What causes chest pain?
Remember, chest pain can be life-threatening and require immediate medical attention, especially if:
- The pain is severe
- You have nausea, are vomiting or sweating
- You have shortness of breath
- You feel unwell or look ill
If you are not experiencing these symptoms, the following details may help you better understand what else could be causing your chest pain.
Any type of damage to the cells of your heart can cause chest pain.
- A heart attack
- Mitral valve disease: This occurs due to an abnormality in the structure of your heart.
- Dissecting aortic aneurysm or the rupture of your aorta: These are potentially fatal issues of your major blood vessels.
- Infection: Chest pain can also be caused by an infection in or around your heart.
The following conditions can either restrict airflow or cause inflammation, both of which lead to chest pain. If you have chest pain and are short of breath, you need to go to the emergency room and be seen right away.
- Pneumothorax: This is when one of your lungs collapses.
- Tumor: This can restrict breathing.
- Embolism: This is a blood clot in your lung.
- Asthma: This can also inhibit breathing.
- Pneumonia: A type of infection that impacts the lungs.
Gastroesophageal reflux disease (GERD) causes a burning sensation in your chest because your esophagus is exposed to the acid from your stomach. Related conditions, such as hiatal hernia and esophagitis, produce a similar sensation. Sometimes this is felt as a sharp pain behind the breastbone and can be associated with regurgitation or other digestive symptoms.
The small muscles between your ribs (intercostal muscles) help your chest expand when you take a deep breath. Injury to these muscles, much like tearing any muscle in your body, will produce pain. Like any other bone, broken ribs will cause pain. Usually, this can be determined if you push on the muscles and they are tender or painful.
Shortness of breath, chest pain, sweating, and numbness in your hands and arms are all classic heart attack symptoms. A case of anxiety (or panic attack) causes symptoms so similar it is often difficult to distinguish between the two. Your doctor can help you through this and help you relax if this is the issue.
GERD (gastroesophageal reflux disease) in infants refers to the passage of stomach contents into the throat causing troublesome symptoms, such as feeding intolerance, inadequate oral intake of calories and/or poor weight gain. Vomiting or visible regurgitation ..
Chest pain from reduced cardiac blood flow (angina pectoris)
Angina pectoris is chest pain that is felt when heart muscle needs more blood than it is currently getting. This may result from coronary artery disease (CAD). CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls.
Top Symptoms: chest pain, chest pain, tight, heavy, squeezing chest pain, moderate chest pain, deep chest pain, behind the breast bone
Symptoms that always occur with chest pain from reduced cardiac blood flow (angina pectoris): chest pain
Symptoms that never occur with chest pain from reduced cardiac blood flow (angina pectoris): productive cough
Urgency: Primary care doctor
A peptic ulcer is a sore in the lining of the stomach or the first part of your small intestine (the duodenum), which causes pain following meals or on an empty stomach.
Top Symptoms: fatigue, nausea, loss of appetite, moderate abdominal pain, abdominal cramps (stomach cramps)
Symptoms that never occur with stomach ulcer: pain in the lower left abdomen
Urgency: Primary care doctor
Atypical chest pain
Atypical chest pain describes the situation when someone's chest pain is unlikely to be related to heart or lung disease. There are many other possible causes that could explain chest pain, like sore chest wall muscles or psychological factors like stress and anxiety.
Top Symptoms: chest pain, shortness of breath
Symptoms that always occur with atypical chest pain: chest pain
Symptoms that never occur with atypical chest pain: fever
Urgency: Primary care doctor
Myocarditis is an inflammation of the heart muscle, also called the myocardium.
It is a rare complication of any viral, bacterial, parasitic, or fungal infection. Reaction to drugs, medications, chemicals, or even radiation can bring about myocarditis.
Anyone with a weakened immune system or pre-existing heart condition is susceptible.
Symptoms include fatigue, chest pain, and shortness of breath, especially following a viral upper respiratory illness. Swelling of the feet and legs from poor circulation may be seen.
If symptoms are severe, take the patient to the emergency room or call 9-1-1. Myocarditis weakens the heart so that it cannot pump blood as it should. Blood clots, stroke, heart attack, abnormal heart rhythm (arrhythmia,) and sudden cardiac death can result without treatment.
Diagnosis is made by electrocardiogram (ECG,) chest x-ray, MRI, echocardiogram, and blood tests.
Short-term treatment is with rest and medication, depending on what kind of illness brought about the myocarditis. Sometimes, devices to support the heartbeat may be surgically implanted.
Long-term treatment may involve medicines such as ACE inhibitors, ARBs, beta blockers, and diuretics.
Top Symptoms: fatigue, headache, shortness of breath, muscle aches, chest pain
Urgency: Hospital emergency room
Acute costochondritis is the inflammation of the flexible cartilage that connects each rib to the breastbone. Costochondritis is caused by excessive coughing or by straining the upper body, as with weightlifti..
Most heart attacks happen when a clot in the coronary artery blocks the supply of blood and oxygen to the heart. Often this leads to an irregular heartbeat - called an arrhythmia - that causes a severe decrease in the pumping function of the heart.
Top Symptoms: chest pain, shortness of breath, tight, heavy, squeezing chest pain, being severely ill, nausea
Urgency: Emergency medical service
Pericarditis (inflammation surrounding the heart)
Pericarditis is a condition in which the membrane, or sac, around the heart is inflamed. This sac is called the pericardium.
Top Symptoms: fatigue, chest pain, being severely ill, fever, deep chest pain, behind the breast bone
Symptoms that always occur with pericarditis (inflammation surrounding the heart): being severely ill
Urgency: Hospital emergency room
An embolus is a blood clot that forms in the bloodstream, breaks loose, and is carried by the blood to become lodged elsewhere in the circulatory system. If this clot (embolus) blocks part of the bloodstream in the lungs (pulmonary system,) this condition is called pulmonary embolis..
A pneumothorax occurs when air or gas leaks into the space (called the pleural space), separating the lung from the chest wall. It puts pressure on the lung, causing the lung to collapse.
Symptoms include sudden, sharp chest pain that worsens with de..
So... which condition is actually causing your chest pain?
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Chest pain treatments and relief
Don't mess around with chest pain. If your chest pain is being caused by a life-threatening condition, emergency care may be needed to save your life.
Not all chest pain is equal. Even when caused by a condition that is not life-threatening, chest pain can still be unsettling and uncomfortable. Conditions such as heartburn or costochondritis (strains or tears in the muscles between your ribs) can be managed at home with over-the-counter medications.
When to see a doctor
It can be hard for you to know whether or not your chest pain is life-threatening. Err on the side of caution. Any new chest pain warrants a trip to the emergency room. However, you can expect to need professional medical care for heart, lung, and other conditions and the proper management of these conditions with follow-up is the best bet for your long-term health.
When it is an emergency
Seek immediate medical care if you have chest pain and:
- Shortness of breath
- Sudden, sharp "ripping" pain
- Profuse sweating
- Nausea and/or vomiting
- You feel dizzy or faint, or actually lose consciousness
- You are coughing up blood
- Painful swallowing
- Pain radiating to your arm, back or neck
- Swelling in your legs
- Rash, fever, or flu-like symptoms
While not all illnesses or injuries that result in chest pain can be prevented, following these recommendations from the American Heart Association can go a long way:
- Maintain a healthy weight
- Complete 150 minutes of moderate exercise each week
- Eat a well-balanced diet: Fruits and vegetables, lean meats and other proteins, healthy fats, and whole grains are essential.
FAQs about chest pain
Can stress cause chest pain?
Yes, stress results in an increased heart rate and can strain the heart. This is especially true for people who have cardiovascular disease or clogged arteries. Extreme emotional stress can also a temporary shut-down of the muscle cells in an area of the heart, but rarely. This is called broken heart syndrome or Takotsubo Syndrome.
What causes chest pain?
Chest pain is caused by a variety of things. It can be caused by inflammation or damage to the esophagus, the lungs, the lining of the lungs, the airway, or the heart. The most concerning causes of chest pain include blood clots that have traveled to the lungs, a tear in the esophagus that is prone to profuse bleeding, a heart attack, or a tear in the aorta.
How do I know if chest pains are serious?
Chest pain or pressure at rest or that worsens with exertion is serious. If you have any signs of dizziness, nausea, sweating, numbness or tingling, confusion, or changes in vision, you should also visit an emergency room. Chest pain associated with any change in your senses, breathing, or state of consciousness may be signs of inadequate blood flow and point to serious circulatory problems.
What causes chest pain on the right side?
Chest pain on the right side can be caused by a heart attack just as frequently as chest pain on the left side. Chest pain on the right side of the body may also be due to pneumonia, broken ribs, torn or strained muscles, viral infections, heartburn, or gallbladder, liver, and pancreas issues.
When should you see a doctor for chest pain?
You should see a doctor for chest pain if it is severe, if it is regular, or if it is accompanied by any other symptoms. If you have dizziness, shortness of breath, or severe chest pain, you should visit an emergency room. If there is a known cause and the pain does not recur, then you may not need to see a doctor. If you get heartburn from eating acidic or very spicy food and find relief with antacids, you can rest at home. If chest pain occurs without eating problematic foods or is caused by increased activity, you should seek treatment.
Questions your doctor may ask about chest pain
- Do you have a cough?
- Do you notice your heart beating hard, rapidly, or irregularly (also called palpitations)?
- Any fever today or during the last week?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Angina and Other Causes of Chest Pain. The Society for Cardiovascular Angiography and Interventions: SecondsCount. SecondsCount Link
- Chest pain: A heart attack or something else? Harvard Health Letter. Updated July 16, 2018. Harvard Health Link
- Mitral Valve Prolapse. Johns Hopkins Medicine Health Library. Johns Hopkins Medicine Link
- 3 Myths About the Causes of Chest Pain. Penn Medicine: Penn Heart and Vascular Blog. Published Feb. 25, 2016. Penn Medicine Link
- Choi WI. Pneumothorax. Tuberc Respir Dis (Seoul). 2014;76(3):99-104. NCBI Link
- Tshimanga P, Daron B, Farhat N, Desprechins B, Gewillig M, Seghaye MC. Exercise-Triggered Chest Pain as an Isolated Symptom of Myocarditis in Children. Clin Pract. 2016;6(2):843. Published April 26, 2016. NCBI Link