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Chest Pain and Cough

Pain when coughing can be caused by a number of illnesses, from mild to serious.

Can a cough cause chest pain?

A cough can cause chest pain if the tissue lining your lungs and chest is irritated (called pleurisy). You may also have pleurisy if you have pain with deep breathing.

Common causes of pleurisy include pneumonia and pleural effusion (fluid in the space between your lungs and your ribs). The common cold does not typically cause chest pain (except in kids or unless you have another condition like asthma).

Another cause of chest pain following coughing is the irritation of your windpipe from conditions like acute bronchitis, pneumonia, or an asthma attack. Chest pain and cough can also be caused by acid reflux.

Lastly, cough and chest pain may be associated with more severe, life-threatening conditions such as

  • Pulmonary embolism (blood clot in lung)
  • Pneumothorax (collapsed lung)
  • Heart failure
  • Esophageal perforation (tearing of the tube that connects your mouth and stomach)

What causes dry cough and chest pain?

Pro Tip

If your cause of chest pain and cough is from pleurisy, it is important to understand what is causing the pleurisy—and if anything more should be done to treat the underlying cause. —Dr. Bina Choi

Pneumonia

Pneumonia is a bacterial or viral infection of the lungs.

Symptoms

Treatment: Antibiotics if it’s a bacterial infection. In severe cases, hospitalization may be necessary.

Bronchitis

Bronchitis is the inflammation of the airways.

Symptoms

  • Persistent cough for weeks, dry or with phlegm
  • Wheezing
  • Difficulty breathing

Treatment: Usually, bronchitis goes away on its own by 3 weeks. Antibiotics generally aren’t needed.

Asthma attack

Asthma is a condition where the airways in your lungs become inflamed and tight, which makes it difficult to breathe. An asthma attack is when your symptoms suddenly become worse than usual.

Symptoms

  • Chest tightness
  • Wheezing
  • Difficulty breathing
  • Fatigue

Treatment: Inhalers and nebulizers as prescribed to use during an allergy attack. Prednisone and allergy medications may also be used. In severe cases, an asthma attack can lead to hospitalization.

Flu

Influenza, or the flu, is a common contagious upper respiratory disease caused by a virus.

Symptoms

  • Fever
  • Muscle aches
  • General malaise
  • Chest pain
  • Runny nose
  • Sore throat

Treatment: Drink plenty of fluids and rest. Your doctor may also prescribe Tamiflu, which can shorten symptoms if the flu is diagnosed early enough.

Pleural effusion

Pleural effusion is unusual fluid in the space between your lungs and ribs.

Symptoms

  • Difficulty breathing
  • Chest pain

Treatment: Your doctor will drain the fluid with a needle placed in your chest or with medications to help you urinate out the fluid. In severe cases, there may be a tube placed in your chest to relieve the fluid.

Pulmonary embolism

A pulmonary embolism is a clot in a blood vessel in the lung. They typically originate in the legs, though they can come from anywhere in the body. This is a medical emergency.

Symptoms

Rarely, some people will experience dizziness or pass out, as well as coughing up blood.

Treatment: Typically, blood thinners are used to help break down the clot and increase blood flow. In severe cases, surgical intervention may be necessary.

Pneumothorax

A collapsed lung, also called a pneumothorax, occurs when air enters the area between the lung and the chest wall, known as the pleural space. This can be life-threatening and is a medical emergency.

Symptoms

Treatment: At the hospital, a tube is inserted into your chest wall to release the air. This allows the lungs to reinflate. Additional monitoring is typically necessary.

Hemothorax

A hemothorax is a pooling of blood between the lung and chest wall. It is often caused by chest trauma, but can also occur in those with blood clotting disorders, lung cancer, or tuberculosis. You should seek treatment immediately.

Symptoms:

  • Injury/trauma to your ribcage
  • Typically, pain is on one side of the chest

Treatment: Usually a tube is inserted into the chest to drain the blood, and additional monitoring follows.

Diffuse alveolar hemorrhage

A diffuse alveolar hemorrhage is when there is bleeding into the lungs.

Symptoms:

  • Fever
  • General malaise
  • Cough with blood
  • Difficulty breathing
  • Chest pain with deep breathing or cough

Treatment: Varied, consult with your doctor. It can be life-threatening, so get treatment fast.

Lung nodules

Also called a pulmonary nodule, a lung nodule is a small abnormal growth in the lung. There are many causes of nodules in the lungs, including lung cancer. Consult with your doctor to figure out the cause and treatment of your nodule.

Symptoms:

  • Varied

Since nodules are often found during CT screenings, it can be hard to identify specific symptoms. Typically they are found when there is chest discomfort that prompts a CT scan.

Treatment: Treatment is varied depending on the cause and type of nodule. Work with your doctor to determine a treatment plan.

Heart failure

Heart failure is an umbrella term, including congestive heart failure and mitral valve disease.

Symptoms

  • Difficulty breathing, especially with activity
  • Swelling in legs or abdomen

Treatment: Medications that make you urinate to get rid of excess fluid. In severe cases, medications to control blood pressure are prescribed. Your doctor will help you decide on what treatment is appropriate for you.

Pericarditis

Pericarditis is a condition in which the membrane, or sac, around the heart is inflamed. This sac is called the pericardium.

Symptoms

Treatment: Varied depending on the underlying cause. Treatment may include non-steroidal anti-inflammatory drugs, colchicine, and sometimes steroids. Hospitalization can be necessary in severe cases.

GERD (acid reflux)

GERD (gastroesophageal reflux disease), also known as acid reflux or heartburn, is when stomach acid flows upwards into the esophagus.

Symptoms

Treatment: Anti-acid medications such as a proton pump inhibitor or histamine H2 receptor antagonist may be prescribed. Many medications are available over-the-counter.

Esophageal perforation

An esophageal perforation is a hole in the esophagus. The esophagus is the tube food passes through as it goes from the mouth to the stomach.

Symptoms:

  • Chest pain after severe episodes of coughing or vomiting

Treatment: This is a very severe condition. Call 911 if you suspect you have an esophageal perforation.

How do I know if my chest pain is serious?

Pro Tip

With many of these causes of chest pain and cough, symptoms can be subtle, vague, and there's not one symptom that is diagnostic. Talk with your doctor if you are not sure. —Dr. Choi

Your pain is very severe or it is accompanied by other symptoms like

  • Difficulty breathing
  • Nausea
  • Sweating
  • Sense of doom
  • Swelling in legs
  • It is a pain you have never felt before

Go to the emergency room if you’re experiencing any of these symptoms.

What does heart attack pain feel like?

The chest pain of a heart attack is not typically accompanied by a cough. A heart attack classically causes pain in the middle of your chest that is pressure-like in nature, as though an elephant is sitting on your chest. The pain can typically go down your left arm or up your neck.

It’s often accompanied by sweating, nausea, and feeling very unwell. However, women, patients who are older, or patients who have diabetes may have subtle and different chest pain symptoms. Talk with your doctor if you are not sure.

Dr. Rx

Be prepared to tell your doctor about any additional accompanying symptoms. Try to have a sense of when the coughing and chest pain occurs or if anything triggers those symptoms or makes them better. Also, for how long you have had symptoms. —Dr. Choi

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