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What's Causing My Chest Pain?
Chest pain is not something to ignore. But you should know that it has many possible causes. In many cases, it's related to the heart. But chest pain may also be caused by problems in your lungs, esophagus, muscles, ribs, or nerves, for example. Some of these conditions are serious and life threatening. Others are not. If you have unexplained chest pain, the only way to confirm its cause is to have a doctor evaluate you.
You may feel chest pain anywhere from your neck to your upper abdomen. Depending on its cause, chest pain may be:
Here are some of the more common causes of chest pain.
These heart problems are common causes:
Coronary artery disease, or CAD. This is a blockage in the heart's blood vessels that reduces blood flow and oxygen to the heart muscle. This can cause pain known as angina. It's a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are at risk for a heart attack in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Angina can be triggered by exercise, excitement, or emotional distress and is relieved by rest.
Myocardial infarction (heart attack). This reduction in blood flow through heart blood vessels causes the death of heart muscle cells. Though similar to angina chest pain, a heart attack is usually a more severe, crushing pain usually in the center or left side of the chest and is not relieved by rest. Sweating, nausea, shortness of breath, or severe weakness may accompany the pain.
Myocarditis. In addition to chest pain, this heart muscle inflammation may cause fever, fatigue, fast heart beat, and trouble breathing. Although no blockage exists, myocarditis symptoms can resemble those of a heart attack.
Pericarditis. This is an inflammation or infection of the sac around the heart. It can cause pain similar to that caused by angina. But it often causes a sharp, steady pain along the upper neck and shoulder muscle. Sometimes it gets worse when you breathe, swallow food, or lie on your back.
Hypertrophic cardiomyopathy. This genetic disease causes the heart muscle to grow abnormally thick. Sometimes this leads to problems with blood flow out of the heart. Chest pain and shortness of breath often occur with exercise. Over time, heart failure may occur when the heart muscle becomes very thickened. This makes the heart work harder to pump blood. Along with chest pain, this type of cardiomyopathy may cause dizziness, lightheadedness, fainting, and other symptoms.
Mitral valve prolapse. Mitral valve prolapse is a condition in which a valve in the heart fails to close properly. A variety of symptoms have been associated with mitral valve prolapse, including chest pain, palpitations, and dizziness, although it can also have no symptoms, especially if the prolapse is mild.
Coronary artery dissection. Many things can cause this rare but deadly condition, which results when a tear develops in the coronary artery. It may cause a sudden, severe pain with a tearing or ripping sensation that goes up into the neck, back, or abdomen.
These are common causes of chest pain:
Pleuritis. Also known as pleurisy, this is an inflammation or irritation of the lining of the lungs and chest. You likely feel a sharp pain when you breathe, cough, or sneeze. The most common causes of pleuritic chest pain are bacterial or viral infections, pulmonary embolism, and pneumothorax. Other less common causes include rheumatoid arthritis, lupus, and cancer.
Pneumonia or lung abscess. These lung infections can cause pleuritic and other types of chest pain, such as a deep chest ache. Pneumonia often comes on suddenly, causing fever, chills, cough, and pus coughed up from the respiratory tract.
Pulmonary embolism. When a blood clot travels through the bloodstream and lodges in the lungs, this can cause acute pleuritis, trouble breathing, and a rapid heartbeat. It may also cause fever and shock. Pulmonary embolism is more likely following deep vein thrombosis or after being immobile for several days following surgery or as a complication of cancer.
Pneumothorax. Often caused by an injury to the chest, pneumothorax happens when a part of the lung collapses, releasing air into the chest cavity. This can also cause pain that gets worse when you breathe as well as other symptoms, such as low blood pressure.
Pulmonary hypertension. With chest pain resembling that of angina, this abnormally high blood pressure in the lung arteries makes the right side of the heart work too hard.
Asthma. Causing shortness of breath, wheezing, coughing, and sometimes chest pain, asthma is an inflammatory disorder of the airways.
COPD. This includes one or more of three disease: Emphysema, chronic bronchitis, and chronic obstructive asthma. The disease blocks airflow by shrinking and damaging both the airways that bring gases and air to and from your lungs and the tiny air sacs (alveoli) that transfer oxygen to your bloodstream and remove carbon dioxide. Smoking is the most common cause.
Gastrointestinal problems can also cause chest pain and include:
Gastroesophageal reflux disease (GERD). Also known as acid reflux, GERD occurs when stomach contents move back into the throat. This may cause a sour taste in the mouth and a burning sensation in the chest or throat, known as heartburn. Things that may trigger acid reflux include obesity, smoking, pregnancy, and spicy or fatty foods. Heart pain and heartburn from acid reflux feel similar partly because the heart and esophagus are located close to each other and share a nerve network.
Esophageal contraction disorders. Uncoordinated muscle contractions (spasms) and high-pressure contractions (nutcracker esophagus) are problems in the esophagus that can cause chest pain.
Esophageal hypersensitivity. This occurs when the esophagus becomes very painful at the smallest change in pressure or exposure to acid. The cause of this sensitivity is unknown.
Esophageal rupture or perforation. A sudden, severe chest pain following vomiting or a procedure involving the esophagus may be the sign of a rupture in the esophagus.
Peptic ulcers. A vague, recurring discomfort may be the result of these painful sores in the lining of the stomach or first part of the small intestine. More common in people who smoke, drink a lot of alcohol, or take painkillers such as aspirin or NSAIDs, the pain often gets better when you eat or take antacids.
Hiatal hernia. This common problem occurs when the top of the stomach pushes into the lower chest after eating. This often causes reflux symptoms, including heartburn or chest pain. The pain tends to get worse when you lie down.
Pancreatitis. You may have pancreatitis if you have pain in the lower chest that is often worse when you lie flat and better when you lean forward.
Gallbladder problems. After eating a fatty meal, do you have a sensation of fullness or pain in your right lower chest area or the right upper side of your abdomen? If so, your chest pain may due to a gallbladder problem.
Sometimes chest pain may result from overuse or an injury to the chest area from a fall or accident. Viruses can also cause pain in the chest area. Other causes of chest pain include:
Rib problems. Pain from a broken rib may worsen with deep breathing or coughing. It is often confined to one area and may feel sore when you press on it. The area where the ribs join the breastbone may also become inflamed.
Muscle strain. Even really hard coughing can injure or inflame the muscles and tendons between the ribs and cause chest pain. The pain tends to persist and it worsens with activity.
Shingles. Caused by the varicella zoster virus, shingles may prompt a sharp, band-like pain before a telltale rash appears several days later.
Another potential cause of chest pain is anxiety and panic attacks. Some associated symptoms can include dizziness, sensation of shortness of breath, palpitations, tingling sensations, and trembling.
When in doubt, call your doctor about any chest pain you have, especially if it comes on suddenly or is not relieved by anti-inflammatory medications or other self-care steps, such as changing your diet.
Call 911 if you have any of these symptoms along with chest pain:
Call your doctor if you have any of these symptoms:
If You Experience Back Pain When You're Sick, This Could Be Why
© kitzcorner/Shutterstock A woman has back pain No one likes getting sick. Catching a cold or getting the flu comes with many potential symptoms including congestion, a runny nose, a sore throat, and fever. If you have also experienced back pain while being sick, you might have wondered why this uncomfortable symptom was added to the list of things you had to deal with. Back pain is actually pretty common when you get sick (via Dr. Stefano Sinicropi).
There are a few reasons why you may experience back pain when you're sick. First, your body is fighting off an infection, which can lead to inflammation. This inflammation can cause the muscles in your back to tense up, leading to pain. Specific illnesses, like pneumonia, affect the lungs and can cause discomfort in the back area. When you're sick, you may also not be getting enough rest or fluid. This can lead to dehydration, which can also cause muscle pain. You may also cough a lot when you're sick, which can strain the muscles in your back and cause them to ache. Finally, some illnesses (like the flu) can cause a high fever. This can cause your muscles to ache as well.
© Prostock-studio/Shutterstock A man has back pain Back pain is an extremely common ailment, even when you aren't sick. There are many reasons you may be experiencing back pain. One possible cause of back pain is muscle strain (via Mayo Clinic). This can happen if you lift something heavy, or if you overuse your muscles. Muscle strain can also occur from poor posture. If you sit or stand in an awkward position for a long period of time, it can put strain on your back muscles and cause pain. Another potential cause of back pain is a herniated disc. This happens when one of the discs in your spine becomes ruptured or damaged. A herniated disc can be very painful, and can even lead to nerve damage.
Other potential causes of back pain include lifestyle triggers like slouching at your desk, lifting heavy objects incorrectly, and not exercising regularly (via WebMD). Women who are pregnant often experience back pain, as well as people with arthritis and osteoporosis. If you're experiencing back pain, talk to your doctor to get a diagnosis and treatment plan.
Read this next: Health Myths You Need To Stop Believing
Here's What To Do If You Have Pain On The Right Side Of Your Chest
© Shutterstock Pain on the right side of your chest can mean anything from a heart attack to a pulled muscle. Here's when to take it seriously. CHEST PAIN CAN feel like your body is setting off an alarm.
Your chest holds tons of vital organs, including your heart and lungs, of course. Medical issues that can arise with these organs can be life-threatening. So, of course, having pain in your chest can feel scary.
Left-sided chest pain is commonly associated with a heart attack. But what about right sided pain? Is it as serious as left-sided pain? What should you do when you feel that kind of pain?
"Chest pain can range from mild in severity to excruciating, innocent to life-threatening, and anywhere in between," says says Joseph Behn, M.D., family medicine physician at Mayo Clinic Health System.
We asked experts when to worry, and when to get help. All your chest pain questions answered, below.
What Can Cause Right-Sided Chest Pain?Unfortunately, the answer is quite broad—there are so many medical conditions that can cause pain in the chest.
It can be as simple as a pulled muscle or as complicated as pulmonary embolism, says Behn. Digestive issues such as acid reflux can radiate pain into the right side of the chest. Several musculoskeletal problems, such as broken ribs and pulled chest or back muscles can also result in pain. Even shingles can cause discomfort in that area.
More serious issues that deal with the heart and lungs are possible, too. Some can be life threatening, but most of them are treatable if help is sought out quickly. These can include esophagus spasms, pneumonia, aortic dissection, atrial fibrillation, and heart failure.
"While many of these conditions are not life threatening, chest pain should always be taken seriously, regardless of which side is affected," says Jonathan Koppel, M.D., assistant professor and general internist at Mount Sinai Hospital.
It's worth noting that it is possible to feel a heart attack on the right side of your chest. Though it's typically noticed on the left side, heart attack pain can be difficult to localize, or the pain can radiate to the other side of the chest. Pain pathways vary widely from person to person, says John Elefteriades, M.D., cardiologist and Men's Health advisor. This means that how the pain surfaces differs for every individual.
How Do You Know if Chest Pain Is Serious?Even though it's possible that heart attack pain can show up on the right side of the chest, if it's only on the right and is very distinct in its location, it's unlikely to be from a heart attack, Koppel says.
How the pain materializes may be a signal of its severity. If you feel it gets worse with exertion, or comes with a shortness of breath, get it checked.
Behn says that new-onset pain that has new symptoms may be a sign that there's something more serious going on. If the new pain comes with sweating, nausea, lightheadedness, it's worth getting checked promptly.
Knowing your family health history and your personal risk factors can help you better evaluate pains like this. "It's best not to simply judge chest pain by the physical location of the pain itself but by a patient's clinical risk factors, the behavior and progression of the pain, and by other associated symptoms," Behn says.
For example, if your family has a history of heart attacks, it's best for you to get help right away if you experience any kind of chest pain. Have a conversation with your doctor about what you are predisposed to so you can be prepared.
When Should I Contact A Doctor About Right-Sided Chest Pain?If the pain feels muscular and doesn't come with any other symptoms, call your doctor to make an appointment to double check. If you're unsure, head to an emergency healthcare facility. It may save your life.
"Oftentimes people might create a story in their mind which allows them to brush off the symptoms such as 'I must have pulled a muscle' or 'I must have eaten something that didn't agree with me'," Behn says. "They may be right. They may be fatally wrong."
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