Chest pain. The first thing you may think of is heart attack. Certainly chest pain is not something to ignore. But you should know that it has many possible causes. 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:
- A tight, squeezing, or crushing sensation
Here are some of the more common causes of chest pain.
A. Heart Problems:
- Angina. A blockage in the heart blood vessels that reduces blood flow and oxygen to the heart muscle itself, causing pain but not permanent damage to the heart. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Chest pain from 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 and is not relieved by rest. Sweating, nausea, or severe weakness may accompany the pain.
- Myocarditis. In addition to chest pain, this heart muscle inflammation may cause fever, fatigue, 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. However, 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. Heart failure occurs when the heart muscle becomes thickened. This makes the heart work harder to pump blood. Along with chest pain, this type of cardiomyopathy may cause dizziness, lightheadedness, shortness of breath, 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. A variety of factors can cause this rare 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.
B. Lungs Problems:
- 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.
- Pneumothorax. Often caused by an injury to the chest, pneumothorax occurs 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.
C. Gastrointestinal Problems:
- 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. Factors 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.
- 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 pain-killers such as aspirin or NSAID’s, the pain often gets better when you eat or take antacids.
- 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.
D. Misc. Problems:
- Rib problems. Pain from a rib fracture 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.
- Anxiety and Panic attacks. Some associated symptoms can include dizziness, sensation of shortness of breath, palpitations, tingling sensations, and trembling.
When to See the Doctor for Chest Pain?
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 your doctor if you have any of these symptoms:
- A sudden feeling of pressure, squeezing, tightness, or crushing under your breastbone.
- Chest pain that spreads to your jaw, left arm, or back.
- Sudden sharp chest pain with shortness of breath, especially after a long period of inactivity.
- Nausea, dizziness, rapid heart rate or rapid breathing, confusion, ashen color, or excessive sweating.
- Very low blood pressure or very low heart rate.
- Fever, chills, or coughing up yellow-green mucus.
- Problems swallowing.
- Severe chest pain that does not go away.