Chest Pain

According to the Centers for Disease Control and Prevention (CDC), chest pain is one of the most common reasons that people ages 15 and older visit the emergency room. In 2008, about nine percent of all ER visits were related to chest pain. (CDC, 2010)

Chest pain varies from person to person. It may feel like a sharp, stabbing pain or a dull ache. While chest pain may be a sign of a serious heart-related problem, it may also have other common, non–life-threatening causes.

When you have chest pain, your first thought may be that you are having a heart attack. While chest pain is a possible sign of a heart problem, many other, less serious conditions can also cause chest pain. Only about 13 percent of all ER visits for chest pain result in a diagnosis of a serious heart-related problem. (CDC, 2010)

Heart-Related Causes of Chest Pain

• heart attack
• angina—chest pain due to blockages in the blood vessels leading to your heart
• pericarditis—inflammation of the sac around the heart
• myocarditis—inflammation of the heart muscle
• cardiomyopathy—heart muscle disease
• aortic dissection—a rare condition involving rupture of the heart’s main artery

Gastrointestinal Causes of Chest Pain

• acid reflux (heartburn)
• swallowing problems related to disorders of the esophagus
• gallstones or inflammation of the gallbladder or pancreas

Lung-Related Causes of Chest Pain

• pneumonia
• viral bronchitis
• pneumothorax—a leak of air from your lung into your chest

Muscle/Bone Causes of Chest Pain

• bruised or broken ribs
• sore muscles from exertion or chronic pain syndromes
• compression fracture, causing pressure on a nerve

Other Causes of Chest Pain

• shingles—an infection of the nerves and skin caused by the chicken pox virus
• panic attack – a sudden episode of intense fear when there is no real danger or cause

Chest pain may be accompanied by other symptoms that will help with diagnosis.

Heart-Related Symptoms

While pain is the most common symptom of a heart problem, some people experience other symptoms, with or without accompanying chest pain. Women in particular have reported atypical symptoms that have later been diagnosed as a heart condition.

• pressure or tightness in the chest
• back, jaw, or arm pain
• fatigue
• feeling light-headed, dizzy, or short of breath
• abdominal pain or nausea
• pain after exertion

Other Symptoms

Symptoms that may indicate your chest pain is not heart-related include:

• sour or acidic taste in your mouth
• pain only after you swallow or eat, or difficulty swallowing
• pain that is better or worse depending on your body position
• pain that is worse when you breathe deeply or cough
• tenderness when you push on your chest
• pain accompanied by a rash
• fever, aches, chills, runny nose, or cough
• feelings of panic or anxiety
• hyperventilating
• back pain that radiates to the front of the chest

If you think you may be having a heart attack, it’s important that you seek emergency treatment immediately, especially if chest pain is new, unexplained, or lasts more than a few moments.

Your doctor will ask a number of questions to help 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:

• electrocardiogram, which records your heart’s electrical activity
• blood tests, to measure enzyme levels
• chest X-ray, to examine heart, lungs, and blood vessels
• echocardiogram, which uses sound waves to record moving images of the heart
• computed tomography (CT) scan, to look for blockages in blood vessels
• magnetic resonance imaging (MRI), which looks for damage to the heart or aorta
• stress tests, to measure your heart function after exertion
• angiogram, to look for blockages in specific arteries

Chest pain might be treated with medication, noninvasive procedures, surgery, or a combination of all of the above.

Heart-Related Treatments

• medications, including nitroglycerin and other artery relaxers, clot-busting drugs, and blood thinners
• cardiac catheterization, using balloons and/or stents to open blocked arteries
• surgical repair of arteries

Other Treatments

• lung re-inflation, in case of a collapsed lung
• antacids or certain procedures for acid reflux and heartburn
• anti-anxiety medications for chest pain related to panic attacks

Many common causes of chest pain can be easily treated and resolved. However, chest pain can also be a symptom of a life-threatening condition.

If you think you may be experiencing a heart attack or other heart problem, seeking medical treatment immediately can help save your heart muscle and your life. Once you have been diagnosed, your doctor can recommend additional treatments to help manage your condition.