Chest pain

Chest pain is best defined as any type of pain or discomfort that occurs between your upper belly area and lower neck. Chest pain is also commonly called angina, and can signal that you are currently experiencing or are at risk for a heart attack. It’s important to seek medical care for any symptoms.

Chest pain is often very uncomfortable and frightening, and it can indicate many different conditions. Some are life-threatening emergencies, like heart attacks and issues affecting the lungs. Others, like constipation, anxiety, and muscle strains, are not as dangerous to your health.

For efficient care and accurate diagnoses with chest pain, seek out an emergency services expert in the Dignity Health network.

Symptoms

In addition to pain, chest pain can produce a variety of other signs and symptoms.

Your history and specific symptom patterns will help your doctor diagnose and treat you as quickly as possible. It is important to tell your doctor what you are experiencing as accurately as you can.

You may feel a tightness, pressure, fullness, or burning sensation in your chest, with some describing their chest pain as sharp, dull, throbbing, crushing, cramping, or achy.

Some of the other symptoms commonly associated with chest pain include:

• Pain that gets worse on activity
• Shortness of breath
• Weakness
• Pain that radiates into the jaw, arm, collarbone, or upper back
• Nausea or vomiting
• Lightheadedness or fainting
• Malaise
• Feeling of a fluttering or rapidly beating heart
• Distended neck veins
• Difficulty breathing
• Cough, chills, shortness of breath
• Fatigue
• Cyanosis (blue lips or extremities)
• Coughing, fever, or chills
• Abdominal pain

If you are having trouble breathing, feel faint, or experience other common symptoms of a heart attack, call 911 right away.

Causes

While many cases of chest pain are due to problems with the heart, chest pain can also be an indicator of lung disease, problems with digestion, or anxiety disorders (particularly panic attacks). For example, possible causes include the following.

Heart-related causes

Causes of chest pain related to problems with the heart or the area surrounding it (also called angina) include:

• Congestive heart failure
• Heart attack
• Heart disease (coronary artery disease)
• Infection or inflammation of the lining of the heart (endocarditis or pericarditis)
• Irregular heart rhythms (arrhythmia) and heart valve problems such as congenital disabilities
• Dissected or ruptured aorta (also called an aortic dissection, referring to a condition in which the major artery leaving the heart has a tear)

Lung-related causes

Issues affecting the lungs may also cause chest pain. Potential lung-related causes include:

• A blood clot or a blockage in an artery in the lung (pulmonary embolism)
• Collapsed lung (pneumothorax)
• Fluid build-up in your lungs (pulmonary edema)
• Inflammation of the lining of the lung (pleurisy)

Digestion-related causes

Rarely, issues with the GI tract can cause referred pain in the upper abdomen or lower chest. Potential causes of chest pain related to the digestive tract include:

• Heartburn, gastroesophageal reflux disease (GERD)
• Gallbladder conditions, such as gallstones
• Esophageal spasm, tear, or disorder
• Gastritis or peptic ulcer

Other causes

In addition to the heart, lungs, and digestive tract, a variety of other conditions can cause chest pain:

• Muscle spasms or strains from overuse or excessive coughing
• Chest wall pain, a benign condition characterized by tenderness in specific points around your sternum (breastbone)
• Anxiety or panic attacks
• Bruises or trauma from injuries
• Fractures to the rib cage, back, collar bone, or sternum
• Cancer

Types

Chest pain can be caused by many different conditions, including those related to the heart and lungs or other tissues in the chest cavity such as the muscles and rib cage, as well as referred pain from the esophagus or upper GI tract.

Cardiac chest pain, or angina, can be stable or unstable. Stable angina is often a persistent, recurring chest pain that generally occurs with exertion and is somewhat predictable. Unstable angina occurs when the chest pain is sudden, new, or changes from the typical pattern. This may signal an upcoming heart attack.

Angina is fairly common but can be hard to distinguish from other types of chest pain, such as the pain or discomfort of indigestion.

Pulmonary embolism occurs when a clot — usually from the veins of your leg or pelvis — lodges in a pulmonary artery of your lung. Lung-related chest pain can cause feelings of tightness that grow worse with breathing or activity.

Risk factors

Risk factors for chest pain depend on the underlying cause. Some factors that can make chest pain more likely include a history of:

• Diabetes. This increases the risk of coronary artery disease, speeding up atherosclerosis, and increasing cholesterol levels.
• Family history. A family history of heart disease puts you at a higher risk of angina.
• High cholesterol or triglyceride levels. High levels of low-density lipoprotein (LDL) cholesterol or triglycerides, a type of blood fat, increases your risk of angina and heart attacks.
• High blood pressure. This damages arteries over time and accelerates the hardening of arteries.
• Obesity. If you’re overweight, the heart has to work harder in order to supply your body with blood. This is connected to high cholesterol, high blood pressure, and diabetes.
• Older age. Men over 45 and women over 55 are at higher risk than young adults.
• Anger and stress can raise your blood pressure, causing a surge in hormones that can narrow your arteries.
• Tobacco use. Using tobacco, including chewing, smoking, and long-term exposure to secondhand smoke, damages your arteries and allows the build-up of cholesterol.

Prevention

Maintaining a healthy heart and avoiding stress and illness can prevent some potential causes of chest pain. For example, some steps you can take include:

• Eating a healthy diet and maintaining a healthy weight
• Exercising
• Getting the flu shot annually
• Limiting alcohol consumption to less than two drinks per day for men and one drink per day for women
• Monitoring other health conditions such as high blood pressure, diabetes, and high cholesterol
• Quitting smoking
• Reducing stress and seeking treatment for anxiety

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.