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Causes of Chest Pain

by | Dec 27, 2022 | Info | 0 comments

Chest Pain Overview

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

Many different problems can cause chest pain. 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.

Chest pain appears in many forms, ranging from a sharp stab to a dull ache. Sometimes chest pain feels crushing or burning. In certain cases, the pain travels up the neck, into the jaw, and then spreads to the back or down one or both arms.

Following some of the possible causes of chest pain:


Heart Problems

Chest pain is one of the five main symptoms of a heart attack. The others are:

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 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.

Myocarditis

Myocarditis is a condition when the heart becomes inflamed, resulting in symptoms that are similar to a heart attack, such as:

  • Chest pain
  • Shortness of breath
  • Fast or irregular heartbeat (tachycardia)

Myocarditis usually results from a viral infection, according to the Centers for Disease Control and Prevention (CDC).

Angina

Angina feels like a 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:

  • Arms
  • Back
  • Jaw
  • Neck
  • Shoulder

Angina can feel like indigestion. It is a symptom of coronary artery disease.

Aortic Aneurism 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.

Coronary Artery Dissection

Coronary artery dissection is when tearing occurs 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.

Pericarditis

Pericarditis is inflammation of the sac around the heart.

It can result in the following:

  • 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
  • Severe chest pain behind the breastbone

Pain may be worse when a person breathes in or is lying down but improves when they sit up or lean forward. It usually results from a viral infection, but there are many other possible causes.


Mitral Valve Prolapse

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

If symptoms occur, they include the following:

  • Chest discomfort
  • Fatigue
  •  Rapid heartbeat


Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is when the heart grows 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 the following:

A person who notices the above symptoms must seek medical help, as it can worsen over time and lead to other complications, such as blood clots and heart failure.


Lung Problems

Various lung problems can cause chest pain.

Asthma

Asthma is a common breathing disorder characterized by inflammation in the airways, which can cause chest pain.

Other symptoms include the following:


Collapsed Lung

When air builds up in the space between the lungs and ribs, leading to a collapsed lung, also known as pneumothorax.

Some people have no symptoms, but the following may occur:

  • Chest pain, which may radiate to the shoulder
  • Discomfort when breathing
  • Faster breathing rate
  • Reduced breathing sounds
  • Shortness of breath
  • Swelling on one side of the chest


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 the following:

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

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
  • Dull, aching, pain or “catching”

Without treatment, it can lead to life threatening complications.

Pneumonia

Lung infections such as pneumonia can cause sharp or stabbing chest pain, especially when breathing deeply or coughing.

Other symptoms of pneumonia include:

  • Bluish tinge to the lips or fingertips
  • Cough up phlegm, which may be green, yellow, or contain blood
  • Confusion (in older patients)
  • Fever sweating, and chills
  • Low appetite, low energy, and fatigue
  • Nausea and vomiting (in young children)
  • Rapid, shallow breathing
  • Shortness of breath

A person with breathing difficulty needs immediate medical attention, as pneumonia can be life threatening.

Pulmonary Embolism

A pulmonary embolism is when a blood clot gets trapped in an artery feeding blood to the lungs.

Common symptoms include:

  • Back pain
  • Blue tinge to lips or nails, known as hypoxia
  •  Chest pain, especially when breathing in
  • Coughing up blood
  • Leg pain or swelling
  • Shortness of breath
  • Sweating
  • Lightheadedness, dizziness, or fainting

Pulmonary embolisms can be life threatening without urgent treatment.

COVID-19

A person with COVID-19 may experience respiratory symptoms, pain, or pressure in the chest.

A person should seek immediate medical help if they have the following conditions:

  • Blue lips or nails
  • Breathing difficulty
  • Difficulty staying awake
  • New confusion
  • Persistent pain or pressure in the chest


Tuberculosis

Tuberculosis (TB)is a bacterial infection that usually affects the lungs.

It can cause the following:

  • A bad cough which may produce blood or sputum
  • Chest pain
  • Fever and night sweats
  • Weight Loss
     

In the past, TB was nearly always fatal. Nowadays, antibiotics can usually treat it successfully.


Gastrointestinal and Digestive Problems

The following conditions affect organs that play a role in digestion. Chest pain can be a symptom.

Pancreatitis

Pancreatitis is an inflammation of the pancreas. Acute pancreatitis usually results from gallstones. Chronic, or long-term pancreatitis stems from genetic features or high alcohol consumption.

A person may notice the following:

  • Fever
  • Nausea and vomiting
  • Swollen or tender abdomen
  • Pain that radiates to the back
  • Upper abdominal pain which may begin suddenly or slowly, be mild or severe, and last several days

If a person notices these symptoms for the first time, they should seek medical help at once.

Esophageal Spasms

Esophageal contraction disorders are spasms or contractions in the food pipe.

Symptoms include the following:

  • Chest pain
  • Difficulty swallowing
  • Heartburn
  • Regurgitation

These disorders can also cause chest pain.

Esophageal Hypersensitivity

In a patient with esophageal hypersensitivity, sensations that are not usually painful can cause severe pain.

Scientists do not know exactly why this happens, but cells in the gullet may be particularly sensitive to acid. Stress may trigger symptoms in people who are susceptible.

Esophageal Rupture

If the food pipe bursts, this can result in sudden, intense chest pain. An esophageal rupture may occur after a procedure involving the esophagus or a traumatic injury.

Other possible symptoms include:

  • A crackling sound on touching the chest
  • Retching and vomiting
  • Shortness of breath or rapid breathing

Peptic Ulcers

Peptic ulcers are sores in the stomach lining.

They can cause the following:

  • Bloating
  • Pain in the abdomen or upper abdomen after eating
  •  Nausea
  • Vomiting, possibly with blood

They do not usually cause intense pain but can result in a recurring discomfort in the chest.


Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux (GERD) refers to when the contents of the stomach move back up into the throat.

It can lead to the following:

  • A cough, hoarseness, or other symptoms in the throat
  • Chest pain
  • Difficulty swallowing or pain when swallowing
  • nausea and vomiting
  • Regurgitation

Over-the-counter antacids can often relieve GERD.


Other Causes

Here are some other reasons chest pain might occur.

Panic Attack

A panic attack is a sudden attack of panic or fear. Often a person does not know why it happens, but it may be a symptom of a condition known as panic disorder.

The individual may experience:

  • A rapid heartbeat
  • Chest pain
  • Dizziness
  • Fear
  • Nausea
  • Sweating
  • Shaking and trembling

The symptoms can resemble those of a heart attack. A doctor may prescribe drugs, counseling, or both to help manage panic disorder.

Hiatal Hernia

A hiatal hernia is when part of the stomach pushes up into the chest. This type of hernia is common and may not cause any symptoms.

However, if the top of the stomach pushes into the lower part of the chest after eating, it can cause symptoms of GERD.

These include:

In some cases, a hiatal hernia may need surgery.

Costochondritis

Costochondritis is inflammation of the cartilage of the rib cage. It can cause pain and tenderness in the chest. The pain may start suddenly.

Costochondritis pain may get worse when:

  • Breathing deeply
  • Doing exercise
  • Coughing or sneezing
  • Lying down


Muscle Strain

Inflammation of the muscles and tendons around the ribs can result in persistent chest pain. If the pain becomes worse with activity, then it may be a symptom of a muscle strain.


Injured Ribs

Injuries to the ribs, such as bruises, breaks, and fractures, can cause chest pain. A person may have heard a crack or felt extreme pain at the time of injury if they have a broken rib.

A person with a fractured rib may have:

  • An inability to breathe in deeply
  • Pain or discomfort in the chest or back
  • Unusual movement in the chest wall


Summary

Chest pain can develop 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.

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