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Chest Pain

Chest pain is one of the most common reasons that people visit the emergency room. Chest pain varies depending on the person. It also varies in:

  • quality
  • intensity
  • duration
  • location

It may feel like a sharp, stabbing pain or a dull ache. It may be a sign of a serious heart-related problem, but it may also occur due to one of many common causes that aren’t life-threatening.

What causes chest pain?

When you have chest pain, your first thought may be that you’re having a heart attack. While chest pain is a well-established sign of a heart attack, it can also be caused by many other less serious conditions. About 13 percent of all ER visits for chest pain result in a diagnosis of a serious heart-related problem.

Heart-related causes of chest pain

The following are heart-related causes of chest pain:

  • a heart attack, which is a blockage of blood flow to the heart
  • angina, which is chest pain due to blockages in the blood vessels leading to your heart
  • pericarditis, which is an inflammation of the sac around the heart
  • myocarditis, which is an inflammation of the heart muscle
  • cardiomyopathy, which is a disease of the heart muscle
  • aortic dissection, which is a rare condition involving a tear of the aorta, the large vessel that comes off of the heart.

Gastrointestinal causes of chest pain

The following are gastrointestinal causes of chest pain:

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

Lung-related causes of chest pain

The following are lung-related causes of chest pain:

  • pneumonia
  • viral bronchitis
  • pneumothorax, which is a leak of air from your lung into your chest
  • a blood clot, or pulmonary embolus
  • bronchospasm, or constriction of your air passages, which commonly occurs in people who have asthma and related disorders such as chronic obstructive pulmonary disease

Muscle- or bone-related causes of chest pain

The following are causes of chest pain related to muscles or bones:

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

Other causes

Shingles, an infection of the nerves and skin that occurs after reactivation of the chickenpox virus, can cause chest pain. You may develop pain along your back or chest before the shingles rash becomes apparent. Panic attacks, which are sudden episodes of intense fear when there’s no real danger or cause, can also cause chest pain.

What symptoms may occur with chest pain?

You may have other symptoms that occur with chest pain. Identifying any symptoms you may be having can help your doctor make a diagnosis. These include:

Heart-related symptoms

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

  • chest pressure or tightness
  • back, jaw, or arm pain
  • fatigue
  • lightheadedness
  • dizziness
  • shortness of breath
  • abdominal pain
  • nausea
  • pain during exertion

Other symptoms

Symptoms that may indicate your chest pain isn’t heart-related include:

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

How is chest pain diagnosed?

Seek emergency treatment immediately if you think you may be having a heart attack and especially if your chest pain is new, unexplained, or lasts more than a few moments.

Your doctor will ask you questions. Your answers can help them 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:

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

How is chest pain treated?

Your doctor might treat chest pain with medication, noninvasive procedures, surgery, or a combination of these methods depending on the cause and severity of your chest pain.

Treatments for heart-related causes of chest pain include:

  • medications, including nitroglycerin and other medications that open partially closed arteries, clot-busting drugs, or blood thinners
  • cardiac catheterization, which involves using balloons or stents to open blocked arteries
  • surgical repair of the arteries, which is also known as coronary artery bypass grafting or bypass surgery

Treatments for other causes of chest pain include:

  • lung re-inflation for a collapsed lung, which your doctor will perform by inserting a chest tube or related device
  • antacids or certain procedures for acid reflux and heartburn
  • anti-anxiety medications for chest pain related to panic attacks

What is the outlook for people with chest pain?

Your doctor can treat and resolve chest pain due to many common conditions, such as:

  • acid reflux
  • anxiety attacks
  • asthma
  • related disorders

However, chest pain can also be a symptom of a life-threatening condition. Seek immediate medical treatment if you think you may be experiencing a heart attack or another heart problem. This can save your life. Once your doctor diagnoses you, they can recommend additional treatments to manage your condition. 

Content licensed from:

Written by: Danielle Moores
Medically reviewed on: Apr 13, 2016: Tyler Walker, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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