Ever felt chest pain while coughing, breathing in, or just sitting still? It might be something as minor as a pinched nerve or a rib out of place. But in some cases, it could be much more serious. So, what causes chest pain, and when should you seek immediate medical attention?
What Exactly Is Chest Pain?
Your chest, the area between your neck and abdomen, houses some of the most vital organs—your heart, lungs, major blood vessels, and esophagus. Chest pain can stem from any of these, or even radiate from another part of your body. It can feel different for everyone—sharp, dull, constant, or intermittent. Understanding what kind of pain you’re experiencing is key to figuring out its cause.
Heart-Related Causes
Coronary Artery Disease (CAD)
This condition occurs when your heart muscle isn’t getting enough oxygen due to narrowed coronary arteries. The culprit? Usually atherosclerosis, the buildup of fatty deposits. Symptoms often appear during exertion, cold exposure, or stress. You might feel a squeezing pain in your chest, sometimes radiating to your jaw, left arm, or shoulder. This is known as angina, and while it typically eases with rest, it’s a red flag for a potential heart attack.
Heart Attack (Myocardial Infarction)
Unlike angina, a heart attack means a coronary artery is completely blocked, cutting off oxygen to part of the heart. This is a life-threatening emergency. The pain is usually intense, feels like something is crushing your chest, and doesn’t improve with rest. It may spread to the jaw, left shoulder, or arm. Other symptoms include sweating, nausea, shortness of breath, and extreme fatigue. Call emergency services immediately if you suspect a heart attack.
Myocarditis
This is inflammation of the heart muscle, often caused by viral infections, autoimmune diseases, or even certain medications. Symptoms include chest pain, irregular heartbeat, fatigue, and shortness of breath. Some people also experience fever and muscle aches.
Pericarditis
Inflammation of the sac surrounding the heart (pericardium) causes sharp pain that worsens with deep breaths, swallowing, or lying down. Oddly enough, leaning forward can make it feel better. Fever and breathing difficulties may also occur.
Hypertrophic Cardiomyopathy
This genetic condition causes the heart muscle to thicken abnormally, making it harder for blood to flow. Symptoms include chest pain, shortness of breath, dizziness, and even fainting spells.
Heart Valve Disorders
If the valves in your heart don’t open and close properly, it can lead to chest pain, irregular heartbeat, shortness of breath, and even blue-tinged lips and fingertips.
Arrhythmia
A heart that beats too fast, too slow, or irregularly can struggle to pump enough oxygen-rich blood to the body, leading to chest pain, dizziness, and even fainting.
Aortic Dissection
This is a medical emergency where the inner wall of the aorta tears, causing severe, stabbing pain in the chest or back. It’s often accompanied by shortness of breath and fainting. If you experience these symptoms, seek medical help immediately.
Non-Heart-Related Causes
Digestive Issues
Acid Reflux (GERD)
When stomach acid backs up into the esophagus, it can cause a burning sensation behind your breastbone—often mistaken for a heart attack. Symptoms worsen after eating and improve when standing up.
Esophageal Spasms
These sudden, painful contractions in your esophagus can mimic heart-related chest pain. Swallowing difficulties and acid reflux may also occur.
Stomach Ulcers
Ulcers can cause burning pain that sometimes radiates to the chest. They’re often triggered by stress, spicy foods, or certain medications.
Gallbladder Issues
Gallstones or inflammation can trigger sharp pain that starts in the abdomen and radiates to the chest and back, especially after fatty meals.
Respiratory Issues
Bronchitis and Pneumonia
Both can cause sharp, stabbing chest pain that worsens with deep breaths or coughing. Fever, chills, fatigue, and difficulty breathing are also common.
Pleurisy
Inflammation of the lining of the lungs can lead to persistent chest pain, which worsens when you breathe deeply or move around.
Pulmonary Hypertension
High blood pressure in the lungs puts extra strain on the heart, leading to chest pain, fatigue, and breathlessness during activity.
Pneumothorax
When air leaks into the space between the lung and chest wall, it can cause sudden, sharp chest pain along with shortness of breath. This condition requires urgent medical attention.
Musculoskeletal Causes
Poor Posture
Bad posture can lead to misalignment of the spine, resulting in chest discomfort. Conditions like scoliosis and kyphosis can also contribute.
Rib Injuries
Bruised, fractured, or misaligned ribs can cause sharp pain, especially with movement, breathing, or coughing.
Costochondritis
Inflammation of the cartilage connecting the ribs to the breastbone can cause stabbing chest pain, often worsened by coughing or pressure.
Muscle Strain
Prolonged coughing or overuse of chest muscles can lead to persistent soreness.
Nervous System Issues
Pinched Nerves
Compressed nerves in the spine or ribs can cause tingling, sharp pain, or a burning sensation in the chest.
Shingles
A viral infection that causes a painful, blistering rash along nerve pathways. The pain can be severe and long-lasting, even after the rash heals.
Psychological Causes
Panic Attacks
These sudden waves of fear can mimic heart attacks. Symptoms include chest tightness, rapid breathing, dizziness, trembling, and a feeling of impending doom. Luckily, they usually subside within minutes.
Depression
Persistent chest pain with no clear medical cause can sometimes be linked to depression and anxiety.
Diagnosing Chest Pain
Doctors use a combination of medical history, physical exams, and tests to determine the cause of chest pain. Common tests include:
- Electrocardiogram (ECG) – Checks heart rhythm
- Echocardiogram – Ultrasound of the heart
- Chest X-ray, CT scan, MRI – Imaging tests for lungs and heart
- Endoscopy – Examines the esophagus and stomach
- Blood tests – Looks for heart attack markers and inflammation
How Is Chest Pain Treated?
Since chest pain has so many possible causes, treatment varies widely. Some common approaches include:
- Heart-related issues: Blood thinners, clot-dissolving drugs, nitrates, blood pressure medications, or surgery (like stent placement or bypass surgery)
- Digestive issues: Antacids, acid reducers, or lifestyle changes
- Respiratory issues: Antibiotics, anticoagulants, or asthma medication
- Muscle-related issues: Pain relievers, rest, or physical therapy
- Psychological issues: Therapy, antidepressants, anti-anxiety medication, or breathing exercises
When to Seek Immediate Medical Help
Call emergency services if you experience:
- Sudden, intense chest pressure that doesn’t improve after five minutes
- Pain spreading to your jaw, left arm, shoulder, or back
- Sharp chest pain with shortness of breath
- Chest pain accompanied by nausea, dizziness, fainting, irregular heartbeat, pale skin, or sweating
Final Thoughts
Chest pain isn’t something to ignore. While some causes are minor, others can be life-threatening. When in doubt, get checked out!
