Chest pain can stem from a heart problem, but other possible causes include a lung infection, muscle strain, a rib injury, or a panic attack. Some of these are serious conditions and need medical attention.

Chest pain is the second biggest cause of emergency room (ER) visits in the United States, leading to over 8 million ER visits every year. Worldwide, chest pain affects 20–40% of the general population.

In this article, learn about some possible causes of chest pain and other symptoms that can help identify them.

Heart problems

1. Heart attack

Chest pain is one of the 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

Females, particularly, may also experience sudden tiredness, nausea, or vomiting.

If someone thinks they are having a heart attack, they should seek emergency medical help. The quicker a person can get to the ER, the quicker treatment can begin.

Getting prompt treatment increases a person’s chances of survival and potentially reduces the severity of the damage to the heart.

How do you recognize the signs of a heart attack?

2. Myocarditis

Myocarditis is inflammation of the heart muscle, resulting in symptoms that are similar to a heart attack, such as:

• chest pain
• shortness of breath
• fast or irregular heartbeat

Myocarditis usually results from a viral infection, according to the British Heart Foundation.

What is an inflamed heart?

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 indigestion.

It is the most common symptom of coronary artery disease.

4. Aortic aneurysm and dissection

Aortic dissection is a tear or separation of the inner layers of the aorta, the main artery that leads from the heart. This can lead to a buildup of blood in the artery.

An aortic aneurysm refers to an enlargement in the aorta. Both conditions can cause the aorta to rupture or burst.

Aortic dissection and a severe aortic aneurysm are emergencies and require immediate medical help. A stable aortic aneurysm may not need emergency treatment.

5. Coronary artery dissection

Coronary artery dissection occurs when there is a tear in the coronary artery wall. If the innermost layer tears, blood can seep through and build up, causing a bulge. It can lead to a heart attack.

Sudden intense pain that appears to “tear” across the chest, neck, back, or abdomen can be a symptom of coronary artery dissection.

This is a rare but serious condition. The American Heart Association (AHA) notes that experts do not know exactly why it happens, but it can affect people without the usual risk factors for heart disease.

6. Pericarditis

Pericarditis is inflammation of the sac around the heart.

It can result in:

• severe chest pain behind the breastbone
• a buildup of fluid around the heart
• cardiac tamponade, when fluid presses on the heart
• obstructive shock, when the heart cannot fill with blood effectively

Possible causes may be infections, malignancy, autoimmune disease, metabolic abnormalities, trauma, and medications. In up to 90% of cases, no clear cause can be found despite extensive testing.

7. Mitral valve prolapse

A mitral valve prolapse is a valve in the heart that is unable to close fully. In mild cases, this condition may have no obvious symptoms.

If symptoms occur, they include:

• rapid heartbeat
• chest discomfort
• fatigue

8. Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is the heart growing too thick due to genetic factors. The thickening of the heart prevents blood from flowing from the heart properly, causing the muscle to work very hard to pump blood.

Symptoms of hypertrophic cardiomyopathy include:

• chest pain
• changes in heart rhythm
• shortness of breath
• dizziness
• lightheadedness
• fainting
• swelling in the feet, ankles, legs, and abdomen

A person who notices this should seek medical advice, as it can worsen over time and lead to other complications, such as blood clots and heart failure.

Various lung problems can cause chest pain.

9. Pulmonary hypertension

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

It can happen for various reasons and can result in:

• breathlessness and faintness when exercising
• shortness of breath when bending down
• fatigue
• swelling due to fluid buildup

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

10. Pleurisy

Pleurisy is inflammation of the membrane that covers the lungs.

Symptoms include:

• chest or shoulder pain
• pain is worse when breathing, coughing, sneezing, or moving the trunk or chest wall
• pain may be dull, aching, or “catching”

Without treatment, it can lead to life threatening complications.

How can pleurisy affect the upper back?

When to contact a doctor

It is always best to contact a doctor if chest pain comes on suddenly, especially if taking anti-inflammatory medications does not ease symptoms.

A person should seek emergency medical help if they have:

• pain that spreads to the arms, back, neck, or jaw
• tightness or heaviness in the chest
• pain that started with nausea, vomiting, sweating
• difficulty breathing or changes in breathing rate
• blue lips or nail beds
• severe pain that lasts longer than 15 minutes
• confusion

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

Takeaway

Chest pain can happen for many reasons. Often, the other signs that occur with it will give an idea of why chest pain occurs.

However, any severe chest pain needs urgent medical attention, especially if it is radiating to the arm, back, or neck, if the heart rate changes, or if the person has trouble breathing.

Anyone with concerns about chest pain should seek medical advice to rule out life threatening causes and obtain suitable treatment.

Conclusion

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