Chest pain is a discomfort in the chest which can be felt anywhere from the neck to the upper abdomen.  Depending on the cause, such a discomfort could be a crushing, squeezing, tight or burning sensation. It also involves pain radiating to the neck or shoulders, sharp stabbing pain or aching in the chest.

What are the causes of chest pain?

Pain in the chest could be due to a problem with the heart, lungs or gastrointestinal track. Also, it may arise from an injury or strain to the muscles, nerves and bones surrounding the chest.  Other causes include viral infection, stress, anxiety and panic attack.

Although you might guess the cause of pain in the chest there is only one way to confirm your guess. This will be to get evaluated by a qualified medical doctor which you can find and book online  at Medicallib.

Reason #1: Heart Problem

chest pain-heart attack

Pain arising from the heart is generally felt in the center of the chest although the heart is located on the left of the chest. Reasons for chest pain arising from the heart include:

  1. The blood vessels (coronary arteries) which transport oxygenated blood to the heart becomes blocked or narrowed. This causes a decrease in blood flow and oxygen to the heart. Narrowing or blockage of coronary arteries is caused by a developing plaque and the pain arising from it is called angina. Such a pain can develop over time as the plaque progress or it can occur suddenly. This is typically a sign that you are likely to develop heart attack. Pain caused by angina is felt as a tight or squeezing sensation in the middle of the chest. Such a pain can spread to your arm, shoulder, jaw or back. Pain due to narrowing of the arteries is worsened by exercising, stress, excitement or cold weather. However, it is easily relieved by rest and peace of mind.
  2. Heart Attack (myocardial infarction)

    A reduction in blood flow and oxygen to the heart causes death of heart muscle cells. Furthermore, the developing plaque can also rupture causing blood clot to accumulate in the ruptured area and block the arteries. These causes heart attack, with symptoms similar to angina but much more severe. Pain can spread from the chest to the neck, back or arms and usually accompanied by body fatigue.
    The pain due to heart attack can be felt either at the center or left side of the chest. Unfortunately, such pain cannot be reduced simply by rest. Note however that instead of a left arm pain as is the norm, women may experience a right arm pain associated with more fatigue, indigestion and nausea.

  3. Rarely, a tear can occur in the coronary arteries causing a terrible pain around the neck, back or abdomen.
  4. Another heart problem that can cause pain in the chest includes inflammation.


    Myocarditis is an inflammation of the heart muscles. Symptoms include tiredness, difficulties breathing, fever and rapid heartbeats.

    Pericarditis is an inflammation of the pericardium, a sac-like tissue which surrounds the heart and keeps it in one place for smooth functioning. It can occur as a result of an infection, injury, heart surgery, heart attack or medication. Pain due to pericarditis fells like a heart attack, and cause a sharp stabbing pain in the chest that can spread to the shoulders and neck.

  5. A genetic condition called hypertrophic cardiomyopathy can cause the heart muscles to become abnormally thick. This makes it difficult for the heart to pump blood. This condition may occur with no symptoms in most cases. But if symptoms do occur, then it will include abnormal heartbeats, difficulties breathing and chest pain especially when exercising since the heart is under strain to pump more blood. Other symptoms include fatigue, dizziness and fainting.

Reason #2: Lungs Problems

chest pain-lungs

Several problems arising from the lungs can result to chest pain

Pneumonia

 Pneumonia is an inflammation which affects the air sacs of the lungs. Consequently, the air sacs become filled with fluid or pus. It can be caused by a bacterial, viral or fungi infection. Symptoms include difficulties breathing, sharp pain in the chest, chills, fever, coughing with phlegm or pus and usually fatigue.

Asthma

The airways or bronchial tubes allow air to come in and out of the lungs. Asthma is a chronic disease causing inflammation, narrowing and swelling of the airways. It also causes the airways to produce extra mucus. Consequently air cannot move in and out of the lungs easily. Symptoms include difficulties breathing, chest tightness or pain, wheezing and coughing.

Pulmonary hypertension

 It is a type of high blood pressure which affects the arteries of the lungs. This causes blood vessels in the lungs to become stiff, damaged or narrowed. As a result, the right side of the heart works harder in order to pump blood. Symptoms include shortness of breath, dizziness, swollen legs, chest pain, palpitations, fatigue, fainting or light headedness.

Pulmonary embolism

 It is a condition whereby blot clot from the legs, pelvis or veins deep in the body (deep vein thrombosis) travels through the blood stream and becomes lodged in the lungs. This obstructs blood flow and decrease oxygen levels in the blood. It also affects other organs since they don’t receive enough oxygen.
Symptoms include shortness of breath, chest pain and cough, fast heartbeat, light headedness, fever, or shock. It is life threatening if not treated quickly and can permanently damage the lungs.

Other causes include cancer complications, or when you stay immobile for several days after a surgery.

Pleuritis

Pleuritis or pleurisy is an inflammation or irritation of the tissues lining the lungs and chest cavity. It may be caused by pulmonary embolism, pneumothorax, bacteria, virus, cancer, rheumatoid arthritis or lupus. Main symptom includes a sharp pain in the chest when breathing, coughing or sneezing. Other symptoms include headache, fever, cough, pain on one side of the chest, shoulders or back and low breathing to avoid pain associated with breathing.

Pneumothorax

 Pneumothorax is a term used to describe a collapsed lung. It happens when air leaks into the pleural cavity of the lungs. Air leakage can be caused by an injury in the chest, a lung disease, a medical procedure or assisted breathing with a ventilator. Symptoms include chest ache, tightness in the chest, fast heart rate or shortness of breath.

Lung Abscess

 Lung abscess is a bacterial infection which causes tissues of the lungs to die and pus to become filled in the lungs cavity. Symptoms include fatigue, chest pain, shortness of breath, night sweats, fever, weight loss or bad breath.

Reason #3: Gastrointestinal Problems

chest pain-stomach

Problems with the esophagus, stomach or intestine can provoke pain in the chest

  1. Gastroesophageal reflux disease (GERD) or Acid Reflux: GERD occurs when the contents of the stomach move backward into the throat. It produces a burning sensation in the chest or throat known as heartburn and also results to a sour taste in the mouth.
  2. Esophageal contraction disorders: It is a disorder which causes involuntary muscle contraction in the esophagus and results to chest pain.
  3. Esophageal hypersensitivity: Though the cause is unknown, it happens when the esophagus becomes very sensitive to the slightest change in pressure or when exposed to an acid. It comes with severe pain.
  4. Esophageal rupture: Severe vomiting or an operation to the esophagus can cause the esophagus to rupture. This produces a sudden and intense pain in the chest.
  5. Hiatal hernia occurs when the top part of the stomach pushes upward into the lower chest through an opening in the diaphragm after eating. Symptoms include heartburn and chest pain which worsen if you lie down immediately after eating.
  6. Pancreatitis: Pancreatitis is an inflammation of the pancreas. This causes pain in the lower chest which get worst if you lie down flat or better if you lean forward.
  7. Peptic ulcers: These are wounds or lesions which occur along the stomach linings or in the upper part of the small intestine. Peptic ulcers can be caused by a bacterial infection, eating spicy food, alcohol abuse, smoking and pain killers such as aspirin.
    Pain caused by peptic ulcer can easily be relieved when you eat or take antacids.
  8. A problem with the gallbladder can cause pain in the right side of the upper abdomen or right side of the lower chest.

Reason #4: Muscle Strain

Muscles and tendons surrounding the ribs can become inflamed or injured by trauma.  This causes a persistent chest pain which worsen with activity or coughing. The affected area is tender when pressed or moved.

Reason #5: Problem with the ribs

Injury or fracture to the ribs causes pain when moving the chest. The pain worsens when you cough or take a deep breath.

Another rib problem that can cause chest pain is costochondritis. This inflammation of the cartilage around the ribs may worsen under any physical activity and when sitting, lying or moving in certain directions.

Rib cancer also results to pain and tenderness at or near the cancerous area. 

Reason #6: Nerve problems

Any nerve in the chest that is crumpled by trauma or injury will result to pain in the chest. Additionally, chest pain around the chest can be caused by the herpes zoster virus. When active, this virus follows the nerve distribution on the chest producing a band-like sharp pain on one side of the chest. The distinctive rash of shingles may develop several days after this pain. 

Reason #7: Psychological problems

This includes panic attacks, anxiety and mental stress.  Symptoms include fear, trembling, rapid breathing, shortness of breath, dizziness, sweating and pain in the chest.

When is it right to see a doctor?

Symptoms associated with chest pain are overlapping and even though you guess the possible cause, it might still be necessary for you to see a qualified medical doctor . Although a general practitioner can help with diagnosis treatment in most cases, sometimes you might need to be referred to a cardiologist (treats heart problems), pulmonologist (treats diseases of the respiratory track) or a gastroenterologist (treats problems of the gastrointestinal track).

See a medical doctor if:

  • The pain comes suddenly and it’s not alleviated or calmed by a pain killer.
  • Pain radiates to your jaws, shoulders, left arm or back
  • You feel a crushing, squeezing, or tightening sensation in your left chest or underneath your sternum.
  • Pain is accompanied by shortness of breath, dizziness, nausea, very fast or very slow heartbeat, sweating, confusion, fever, chills or coughing.
  • You experience difficulties when swallowing or sleeping in certain positions.