Common causes of chest pain

November 12, 2019

Providence Heart & Vascular Team

[4 MIN READ]

There are many sources of chest pain, including problems with the lungs, muscles, and digestive system.
Chest pain should always be investigated by a doctor, even if it isn’t a heart attack.
Providence physicians say the coronavirus pandemic may have contributed to chest pains including stress and breathing problems.

No matter your gender or age, chest pain can be a concerning symptom for anyone. When chest pain happens, our minds often jump to heart attacks and heart disease. And after living through the COVID-19 global pandemic, we have even more reasons to be wary of chest pain.

While all chest pain should be taken seriously, it’s not always caused by a heart attack and you don’t always have to rush to the emergency room. In fact, there are many different sources of chest pain, including the lungs, muscles, and digestive system.

Let’s take a look at some of the different reasons why you may have chest pain.

Digestive issues

Feeling chest pain or burning in your upper body after a spicy meal? It may be acid indigestion — also known as heartburn.

Although it may be called “heartburn,” the chest pain you feel with acid indigestion is in your esophagus. The pain is caused by stomach acids creeping up into your throat.

Heartburn associated with acid indigestion often spreads into the throat or neck. It may also go away after belching.

Other digestive issues that can cause chest pain include:

Swallowing problems – These conditions are often caused by spasms in the esophagus.
Gallstones – Problems with your gallbladder can sometimes cause pain that radiates into the chest. This pain is often worse after a fatty meal. Gallstone pain often starts in the pit of your stomach or the upper right side of your abdomen and can spread to the upper right side of your back.

Muscle tear or chest injury

If you worked out a little too hard at the gym, you might feel some chest pain caused by sore or injured muscles — also called a chest wall strain. You can pull muscles in your chest after lifting heavy objects or weights, strenuous exercise or excessive coughing.

Rib injuries, like a bruised or broken rib, can also sometimes cause chest pain.

In some cases, chronic pain conditions like fibromyalgia can create sore muscles in the chest.

Panic attacks

Sudden, intense periods of fear — also called panic attacks — can often come with chest pain. These attacks can also cause sweating, rapid heart rate and trouble breathing.

While panic attacks are uncomfortable, they are not uncommon. They can last for several minutes or sometimes longer, but once the attack is over the chest pain should subside. Frequent panic attacks may be caused by an anxiety disorder called panic disorder.

Heart attacks and other heart conditions

A heart attack is most often associated with chest pain. Heart attacks happen when blood cannot flow through your heart, usually caused by a buildup of plaque in the arteries. The chest pain (also called angina) you experience during a heart attack will come on suddenly and feel tight, often with a squeezing or crushing sensation.

Aside from heart attacks, chest pain can be caused by:

Pericarditis – This condition happens when the sac around the heart becomes inflamed. With pericarditis, you typically feel pain in the center of your chest.

Aortic dissection – This is a tear in the wall of the aorta, which is the main artery that carries blood from the heart. This condition happens when the layers of the aorta’s wall weaken over time and separate, causing blood to get in between the layers and rupture the wall. The chest pain is sudden and can feel like ripping or tearing, often spreading to the upper back. Aortic dissection is relatively uncommon, but it is a life-threatening emergency that needs to be treated immediately.

Injury or inflammation in the lungs

Sometimes a serious problem with the lungs can cause chest pain and difficulty breathing. These problems can include:

Pleurisy – This happens when the lining around the lung swells. Chest pain with pleurisy usually gets worse when you cough or breathe deeply.
Collapsed lung – This condition, also called pneumothorax, happens when air gets in-between the lungs and the ribs. A collapsed lung can cause shortness of breath and sudden chest pain that lasts for hours.
Pulmonary embolism – When a blood clot gets stuck in one of the arteries in your lungs (pulmonary artery), it blocks blood flow and can cause sharp chest pain that feels similar to a heart attack.
Pneumonia – This type of lung infection can cause chest pain when you cough or take deep breaths.

When should I call a doctor?

If you suddenly have unexplained chest pain or suspect you are having a heart attack, call 9-1-1 immediately.

You should also call 9-1-1 if:

You feel a tight, crushing, or squeezing sensation in your chest.
You have pain that spreads from your chest to your left arm, between your shoulder blades or to your jaw.
You experience shortness of breath or a racing heart.
You feel nauseous or dizzy while experiencing chest pain.
You have been diagnosed with angina and it is suddenly worse or you feel symptoms while resting.

Even if you have mild chest pain, it’s still important to see a doctor, especially if the pain lasts for more than three days. Your doctor will be able to determine whether the pain is caused by something serious and if it requires treatment.

Find a doctor

If you need advice on what could be causing your chest pain, talk to your doctor. You can find a Providence cardiologist using our provider directory.

Through Providence Express Care Virtual, you can also access a full range of healthcare services.