Causes Of Chest Pain

Chest pain can be a symptom of heart problems, but it can have many other causes. Some of these are serious conditions, but most are not harmful.

Chest pain is the second leading cause of emergency room (ER) visits in the United States, with more than 8 million emergency room visits each year. Chest pain affects 20-40% of the general population worldwide.

Heart problems

Various heart problems that can cause pain in the chest are:

1. Heart attack

Chest pain is one of the five main symptoms of a heart attack. The others are:

• pain in the jaw, neck or back

• lightheadedness or weakness

• pain in the arms or shoulders

• shortness of breath

Sudden fatigue, nausea, or vomiting can also occur, especially in women.

If you think you are having a heart attack, you should seek medical attention. The sooner you get to the emergency room, the sooner the treatment can begin.

Prompt treatment may increase the chances of survival and reduce the severity of heart damage.

2. Myocarditis

Myocarditis is when the heart becomes inflamed, resulting in symptoms that are similar to a heart attack, such as:

• chest pain

• shortness of breath

• fast or irregular heartbeat

3. Angina

Angina feels like squeezing pain or pressure on the chest. It occurs when not enough blood is getting to the heart. A person may also feel pain in the:

• shoulder

• back

• neck

• arms

• jaw

Angina can feel like indigestion. It is a symptom of coronary artery disease.

4. Aortic aneurism and dissection

Aortic dissection is a tear or detachment of the lining of the aorta, the main artery away from the heart. This can cause blood to pool in the arteries.

An aortic aneurysm is an enlargement of a main artery.

Both conditions can cause the aorta to tear or rupture.

Aortic dissection and severe aortic aneurysm are emergencies that require immediate medical attention. Stable aortic aneurysms may not require emergency treatment.

5. Pericarditis

Pericarditis is inflammation of the sac around the heart.

It can cause:

• severe chest pain behind the sternum

• fluid accumulation around the heart

• Cardiac tamponade, in which fluid presses against the heart

• Obstructive shock when the heart does not fill with enough blood

The pain may get worse when the person breathes or lies down, but improves when the person sits or bends over.

It is usually caused by a viral infection, but there are many other possible causes.

6. Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is a condition in which the heart is overweight due to genetic factors. When the heart thickens, blood does not flow properly from the heart and the muscles have to work very hard to get the blood pumping.

Symptoms of hypertrophic cardiomyopathy include:

• chest pain

• change in heart rhythm

• difficulty breathing

• dizzy

• sleepiness

• syncope

• Swelling of feet, ankles, legs, and abdomen

Anyone who notices this should seek medical attention as it can get worse over time and lead to other complications such as blood clots and heart failure.

Lung problems

Various lung problems that can cause chest pain are:

1. Pulmonary hypertension

Pulmonary hypertension is high blood pressure in the arteries that carry blood to the lungs. In some cases, this can lead to chest pain.

This can happen for various reasons and can be caused by:

• Shortness of breath or fainting during exercise

• shortness of breath when bending over

• Malaise

• Swelling due to fluid accumulation

Pulmonary hypertension is not usually immediately life-threatening, but it does require medical attention.

2. Pneumonia

Lung infections such as pneumonia can cause sharp or stabbing chest pain, especially when breathing deeply or coughing.

Other symptoms of pneumonia include:

• fever, sweating, and chills

• coughing up phlegm, which may be green, yellow, or contain blood

• shortness of breath

• bluish tinge to the lips or fingertips

• rapid, shallow breathing

• low appetite, low energy, and fatigue

• nausea and vomiting (in young children)

• confusion (in older people)

A person with breathing difficulty needs immediate medical attention, as pneumonia can be life threatening.

3. Pulmonary embolism

A pulmonary embolism is a condition in which a blood clot becomes trapped in an artery that carries blood to the lungs.

Common symptoms include:

• chest pain, especially when breathing in

• back pain

• difficulty breathing

• Blood vomit

• leg pain and swelling

• Sweat

• Light headedness, dizziness or fainting

• Blue discoloration of lips and nails known as hypoxia

Pulmonary embolism can be life threatening without prompt treatment.

4. Tuberculosis

Tuberculosis (TB) is a bacterial infection that usually affects the lungs.

It can cause:

• chest pain

• A bad cough with blood or sputum

• weight loss

• fever and night sweats

5. Asthma

Asthma is a common breathing disorder characterized by inflammation in the airways, which can cause chest pain.

Other symptoms include:

• tightness in the chest

• shortness of breath

• coughing

• wheezing

Gastrointestinal and digestive problems

The following conditions affect organs that play a role in digestion. Chest pain can be a symptom.

1. Gastroesophageal reflux disease (GERD)

GERD refers to when the contents of the stomach move back up into the throat.

It can lead to:

• chest pain

• regurgitation

• nausea and vomiting

• difficulty swallowing or pain when swallowing

• a cough, hoarseness, or other symptoms in the throat

Over-the-counter antacids can often relieve GERD.

2. Esophageal spasms

Esophageal contraction disorders are spasms or contractions in the food pipe.

Symptoms include:

• chest pain

• difficulty swallowing

• regurgitation

• heartburn

These disorders can also cause chest pain.

3. Esophageal hypersensitivity

In people with esophageal hypersensitivity, normally painless sensations can cause severe pain.

Experts don't know exactly why this happens, but cells in the esophagus may be particularly sensitive to acid.Stress can trigger symptoms in susceptible individuals.

4. Esophageal rupture

A ruptured esophagus can cause sudden, severe chest pain. Esophageal rupture can occur after esophageal surgery or trauma.

Other possible symptoms are:

• nausea and vomiting

• Crackling sound when touching the chest

• shortness of breath or rapid breathing

5. Peptic ulcers

Peptic ulcers are sores in the stomach lining.

They can cause:

• pain in the abdomen or upper abdomen after eating

• bloating

• nausea

• vomiting, possibly with blood

They do not usually cause intense pain but can result in a recurring discomfort in the chest.

Other causes

Here are some other reasons chest pain might occur.

Muscle strain

Inflammation of the muscles and tendons around the ribs can cause persistent chest pain.If activity makes the pain worse, it may be a symptom of muscle tightness.

Panic attack

A panic attack is a sudden attack of panic or fear. Often a person does not know why it happens, but it may be a symptom of a condition known as panic disorder.

The individual may experience:

• chest pain

• a rapid heartbeat

• fear

• nausea

• dizziness

• sweating

• shaking and trembling

The symptoms can resemble those of a heart attack.

A doctor may prescribe drugs, counseling, or both to help manage panic disorder.

Hiatal hernia

A hiatal hernia is when part of the stomach pushes up into the chest. This type of hernia is common and may not cause any symptoms.

However, if the top of the stomach pushes into the lower part of the chest after eating, it can cause symptoms of GERD.

These include:

• chest pain

• reflux

• heartburn

In some cases, a hiatal hernia may need surgery.

When to see a doctor

It's always a good idea to see a doctor if you have sudden chest pain, especially if anti-inflammatory medication doesn't help.

You should seek medical help for:

• pain that radiates to the arm, back, neck, or jaw

• tightness or heaviness in the chest

• Pain that begins with nausea, vomiting, and sweating

• difficulty breathing or a change in breathing rate

• blue lips or nail beds

• Severe pain lasting more than 15 minutes

In some cases, chest pain can be life-threatening. For this reason, one should not ignore it.

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