What's Causing My Chest Pain?
Chest pain. The first thing you may think of is
heart attack.
Certainly chest pain is not something to ignore. But you should know
that it has many possible causes. In fact, as much as a quarter of the
U.S. population experiences chest pain that is not related to the
heart. Chest pain may also be caused by problems in your
lungs,
esophagus,
muscles, ribs, or nerves, for example. Some of these conditions are
serious and life threatening. Others are not. If you have unexplained
chest pain, the only way to confirm its cause is to have a doctor
evaluate you.
You may feel chest pain anywhere from your neck to your upper
abdomen. Depending on its cause, chest pain may be:
- Sharp
- Dull
- Burning
- Aching
- Stabbing
- A tight, squeezing, or crushing sensation
Here are some of the more common causes of chest pain.
Chest Pain Causes: Heart Problems
Although not the only cause of chest pain, these heart problems are common causes:
Coronary Artery Disease, or CAD. A blockage in the heart
blood vessels that reduces
blood flow and oxygen to the heart muscle itself. This can
cause pain known as
angina. It's a symptom of
heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are a candidate for a
heart attack at some point in the future. The chest pain may spread to your arm,
shoulder, jaw, or back. It may feel like a pressure or squeezing sensation.
Angina can be triggered by
exercise, excitement, or emotional distress and is relieved by rest.
Myocardial infarction (heart attack).
This reduction in blood flow through heart blood vessels causes the
death of heart muscle cells. Though similar to angina chest pain, a
heart attack is usually a more severe, crushing pain usually in the
center or left side of the chest and is not relieved by rest.
Sweating,
nausea, shortness of breath, or severe
weakness may accompany the pain.
Myocarditis. In addition to chest pain, this heart muscle inflammation may cause fever,
fatigue, fast heart beat, and
trouble breathing. Although no blockage exists, myocarditis symptoms can resemble those of a heart attack.
Chest Pain Causes: Heart Problems continued...
Pericarditis.
This is an inflammation or infection of the sac around the heart. It
can cause pain similar to that caused by angina. However, it often
causes a sharp, steady pain along the upper neck and shoulder muscle.
Sometimes it gets worse when you breathe, swallow food, or lie on your
back.
Hypertrophic cardiomyopathy. This
genetic disease causes the heart muscle to grow abnormally thick.
Sometimes this leads to problems with blood flow out of the heart. Chest
pain and shortness of breath often occur with
exercise. Over time,
heart failure
may occur when the heart muscle becomes very thickened. This makes the
heart work harder to pump blood. Along with chest pain, this type of
cardiomyopathy may cause
dizziness, lightheadedness,
fainting, and other symptoms.
Mitral valve prolapse.
Mitral valve prolapse is a condition in which a valve in the heart
fails to close properly. A variety of symptoms have been associated with
mitral valve prolapse, including chest pain, palpitations, and
dizziness, although it can also have no symptoms, especially if the prolapse is mild.
Coronary artery dissection.
A variety of factors can cause this rare but deadly condition, which
results when a tear develops in the coronary artery. It may cause a
sudden severe pain with a tearing or ripping sensation that goes up into
the neck, back, or abdomen.
Chest Pain Causes: Lung Problems
Problems with the lungs can cause a variety of types of chest pain. These are common causes of chest pain:
Pneumonia or lung abscess.
These lung infections can cause pleuritic and other types of chest
pain, such as a deep chest ache. Pneumonia often comes on suddenly,
causing fever, chills,
cough, and pus coughed up from the respiratory tract.
Chest Pain Causes: Lung Problems continued...
Pulmonary embolism. When a
blood clot
travels through the bloodstream and lodges in the lungs, this can cause
acute pleuritis, trouble breathing, and a rapid heartbeat. It may also
cause fever and shock. Pulmonary embolism is more likely following
deep vein thrombosis or after being immobile for several days following surgery or as a complication of
cancer.
Pneumothorax.
Often caused by an injury to the chest, pneumothorax occurs when a part
of the lung collapses, releasing air into the chest cavity. This can
also cause pain that gets worse when you breathe as well as other
symptoms, such as
low blood pressure.
Chest Pain Causes: Gastrointestinal Problems
Gastrointestinal problems can also cause chest pain and include:
Gastroesophageal reflux disease (GERD). Also known as
acid reflux, GERD occurs when
stomach contents move back into the throat. This may cause a sour taste in the
mouth and a burning sensation in the chest or throat, known as
heartburn. Factors that may trigger
acid reflux include
obesity,
smoking,
pregnancy, and spicy or fatty foods. Heart pain and
heartburn from acid reflux feel similar partly because the heart and esophagus are located close to each other and share a nerve network.
Esophageal contraction disorders. Uncoordinated muscle
contractions (spasms) and high-pressure
contractions (nutcracker esophagus) are problems in the esophagus that can cause chest pain.
Esophageal hypersensitivity.
This occurs when the esophagus becomes very painful at the smallest
change in pressure or exposure to acid. The cause of this sensitivity is
unknown.
Esophageal rupture or perforation. A sudden, severe chest pain following
vomiting or a procedure involving the esophagus may be the sign of a rupture in the esophagus.
Peptic ulcers.
A vague recurring discomfort may be the result of these painful sores
in the lining of the stomach or first part of the small intestine. More
common in people who smoke, drink a lot of alcohol, or take pain-killers
such as
aspirin or NSAID’s, the pain often gets better when you eat or take antacids.
Chest Pain Causes: Gastrointestinal Problems continued...
Hiatal hernia.
This common problem occurs when the top of the stomach pushes into the
lower chest after eating. This often causes reflux symptoms, including
heartburn or chest pain. The pain tends to get worse when you lie down.
Pancreatitis. You may have
pancreatitis if you have pain in the lower chest that is often worse when you lie flat and better when you lean forward.
Gallbladder problems.
After eating a fatty meal, do you have a sensation of fullness or pain
in your right lower chest area or the right upper side of your abdomen?
If so, your chest pain may due to a gallbladder problem.
Chest Pain Causes: Bone, Muscle, or Nerve Problems
Sometimes
chest pain may result from overuse or an injury to the chest area from a
fall or accident. Viruses can also cause pain in the chest area. Other
causes of chest pain include:
Rib problems. Pain from a rib fracture may worsen with deep breathing or
coughing.
It is often confined to one area and may feel sore when you press on
it. The area where the ribs join the breastbone may also become
inflamed.
Muscle strain.
Even really hard coughing can injure or inflame the muscles and tendons
between the ribs and cause chest pain. The pain tends to persist and it
worsens with activity.
Shingles. Caused by the varicella
zoster virus, shingles may prompt a sharp, band-like pain before a telltale
rash appears several days later.
Other Potential Causes of Chest Pain
Another potential cause of chest pain is
anxiety and panic
attacks. Some associated symptoms can include dizziness, sensation of
shortness of breath, palpitations, tingling sensations, and trembling.
When to See the Doctor for Chest Pain
When
in doubt, call your doctor about any chest pain you have, especially if
it comes on suddenly or is not relieved by anti-inflammatory
medications or other self-care steps, such as changing your diet.
Call 911 if you have any of these symptoms along with chest pain:
- A sudden feeling of pressure, squeezing, tightness, or crushing under your breastbone
- Chest pain that spreads to your jaw, left arm, or back
- Sudden sharp chest pain with shortness of breath, especially after a long period of inactivity
- Nausea, dizziness, rapid heart rate or rapid breathing, confusion, ashen color, or excessive sweating
- Very low blood pressure or very low heart rate
Call your doctor if you have any of these symptoms:
- Fever, chills, or coughing up yellow-green mucus
- Problems swallowing
- Severe chest pain that does not go away
