When you have chest pain, your first thought may be that it’s a heart attack. However, other less serious conditions can also cause chest pain.
Chest pain is one of the most common reasons that people visit the emergency room (ER). Chest pain varies depending on the person. It also varies in:
quality
intensity
duration
location
It may feel like a sharp, stabbing pain or a dull ache. It may be a sign of a serious heart-related problem or due to a common cause that isn’t life threatening.
What causes chest pain?
When you have chest pain, your first thought may be that you’re having a heart attack. While chest pain is a well-established sign of a heart attack, it can also be caused by many other less serious conditions.
According to one study, only 5.5 percent of all ER visits for chest pain result in a diagnosis of a serious heart-related problem.
Heart-related causes of chest pain
The following are heart-related causes of chest pain:
heart attack, which is a blockage of blood flow to the heart
angina, which is chest pain caused by blockages in the blood vessels leading to your heart
pericarditis, which is an inflammation of the sac around the heart
myocarditis, which is an inflammation of the heart muscle
cardiomyopathy, which is a disease of the heart muscle
aortic dissection, which is a rare condition involving a tear of the aorta, the large vessel that comes off of the heart
Gastrointestinal causes of chest pain
The following are gastrointestinal causes of chest pain:
acid reflux, or heartburn, especially after eating
swallowing problems related to disorders of the esophagus
gallstones, which can lead to upper abdominal pain or pain after eating
inflammation of the gallbladder or pancreas
Lung-related causes of chest pain
The following are lung-related causes of chest pain:
pneumonia, which causes pain that may get worse with breathing
viral bronchitis, which can cause soreness around your chest and muscle aches
pneumothorax (collapsed lung), causing a sudden onset of chest pain
a blood clot, or pulmonary embolus, which can cause sharp pain that worsens with breathing
bronchospasm, which causes chest tightness
Bronchospasms commonly occur in people who have asthma and related disorders such as chronic obstructive pulmonary disease (COPD).
Muscle- or bone-related causes of chest pain
The following are causes of chest pain related to the muscles or bones:
bruised or broken ribs, which may be due to an injury to your chest
sore muscles from exertion or chronic pain syndromes
compression fractures causing pressure on a nerve
Other causes
Shingles can cause chest pain. You may develop pain along your back or chest before the shingles rash becomes apparent. Panic attacks can also cause chest pain.
What symptoms may occur with chest pain?
You may have other symptoms that occur with chest pain. Identifying symptoms you may be having can help your doctor make a diagnosis. These include:
Heart-related symptoms
While pain is the most common symptom of a heart problem, some people experience other symptoms, with or without chest pain. Women, in particular, may report atypical symptoms that are later identified as being the result of a heart condition:
chest pressure or tightness
back, jaw, or arm pain
fatigue
lightheadedness
dizziness
shortness of breath (dyspnea)
abdominal pain
nausea
pain during exertion
Other symptoms
Symptoms that may indicate your chest pain isn’t heart-related include:
a sour or acidic taste in your mouth
pain that only occurs after you swallow or eat
difficulty swallowing
pain that’s better or worse depending on your body position
pain that’s worse when you breathe deeply or cough
pain accompanied by a rash
fever
aches
chills
runny nose
cough
feelings of panic or anxiety
hyperventilating
back pain that radiates to the front of your chest
How is chest pain diagnosed?
Seek emergency treatment immediately if you think you may be having a heart attack and especially if your chest pain is new, unexplained, or lasts more than a few moments.
Your doctor will ask you some questions, and your answers can help them diagnose the cause of your chest pain. Be prepared to discuss any related symptoms and to share information about any medications, treatments, or other medical conditions you may have.
Diagnostic tests
Your doctor may order tests to help diagnose or eliminate heart-related problems as a cause of your chest pain. These may include:
an electrocardiogram (ECG or EKG), which records your heart’s electrical activity
blood tests, which measure enzyme levels
a chest X-ray, which is used to examine your heart, lungs, and blood vessels
an echocardiogram, which uses sound waves to record moving images of your heart
an MRI, which is used to look for damage to your heart or aorta
stress tests, which are used to measure your heart function after exertion
an angiogram, which is used to look for blockages in specific arteries
If you need help finding a primary care doctor, you can browse doctors in your area through the tool.
How is chest pain treated?
Your doctor might treat chest pain with medication, noninvasive procedures, surgery, or a combination of these methods. Treatment depends on the cause and severity of your chest pain.
Treatments for heart-related causes of chest pain include:
medications, which may include nitroglycerin and other medications that open partially closed arteries, clot-busting drugs, or blood thinners
cardiac catheterization, which may involve using balloons or stents to open blocked arteries
surgical repair of the arteries, which is also known as coronary artery bypass grafting or bypass surgery
Treatments for other causes of chest pain include:
lung reinflation for a collapsed lung, which your doctor will perform by inserting a chest tube or related device
antacids or certain procedures for acid reflux and heartburn, which are used to treat the symptoms
anti-anxiety medications, which are used to treat chest pain related to panic attacks
What is the outlook for people with chest pain?
Your doctor can treat and resolve chest pain caused by many common conditions. These may include acid reflux, anxiety attacks, and asthma or related disorders.
However, chest pain can also be a symptom of a life threatening condition. Seek immediate medical treatment if you think you may be experiencing a heart attack or another heart problem. This can save your life.
Once your doctor makes a diagnosis, they can recommend additional treatments to help you manage your condition.
