Key takeaways
- Chest pain can result from many conditions beyond heart problems, including muscle strain, gastrointestinal issues like heartburn or acid reflux, anxiety or panic attacks, and respiratory infections.
- Heart-related chest pain often feels like tightness, squeezing, or pressure and may spread to the jaw, arm, back, or neck. Other serious causes include lung conditions like pulmonary embolism or pneumothorax.
- A person should get immediate medical attention if they experience sudden, severe chest pain with sweating, lightheadedness, difficulty breathing, or pain radiating to other body parts, as these may signal a heart attack.
Chest pain is the second most common cause of emergency room (ER) visits in the United States, accounting for over 8 million visits each year.
There are many causes of chest pain, and it is important to note that many do not require immediate medical attention. Prompt diagnosis and treatment can improve health outcomes, so it is essential to know which causes of chest pain require medical assistance.
This article examines the causes and symptoms of chest pain and when to connect with a healthcare professional.
When to get immediate medical attentionA person should get immediate medical attention if they, or someone they are with, experiences any of the following symptoms:
- sudden, severe chest pain
- chest pain that feels like tightness, squeezing, burning, or indigestion
- pain that spreads to the shoulder, arm, back, or jaw
- pain and other symptoms, such as shortness of breath, sweating, lightheadedness, and dizziness
These may be signs of a heart attack, which requires immediate medical attention and treatment.
Learn more: How to recognize the signs of a heart attack
People describe chest pain in many different ways, and it is likely to feel different depending on the underlying cause. According to the British Foundation, chest pain may feel like:
- tightening
- squeezing
- tingling
- stabbing
- burning
- pressure, as if someone is sitting on you
Chest pain may be localized, meaning it affects only one area of the chest, such as the left, right, or central (sternum) areas. The pain may also start in one area and radiate to other areas of the chest.
The severity may also vary. For instance, it can be brief or constant, mild or severe.
In many cases, chest pain is not caused by a heart condition or other condition requiring emergency medical treatment.
Some common causes of chest pain include:
- strain, inflammation, or injury to the muscles and tendons around the chest and ribs
- gastrointestinal symptoms, such as acid reflux causing heartburn, and belching
- anxiety, depression, or a panic attack, which may cause a rapid heart rate, trembling, fear, and shortness of breath
- infections, such as bronchitis, COVID-19, tuberculosis (TB), and pneumonia
- respiratory conditions, such as asthma
A person should consider speaking with a healthcare professional if they experience chest pain that does not improve after a few days or is accompanied by symptoms such as skin tingling, fever, or shortness of breath.
A doctor can develop an appropriate treatment plan tailored to an individual’s needs.
Various heart-related conditions may cause sudden, severe chest pain that often feels like chest tightening, squeezing, or tearing. This pain can radiate to the jaw, back, neck, or other areas.
Some of the heart-related conditions that may cause chest pain
- heart attack, which occurs when there is a
loss of blood supply to the heart muscle - myocarditis, which is
inflammation of the heart muscle - angina, which occurs when not enough blood gets to the heart
- aortic dissection, which is a tear or separation of the inner layers of the aorta, the main artery that leads from the heart
- aortic aneurysm, which refers to an enlargement of the aorta
- coronary artery dissection, which occurs when there is a tear in the coronary artery wall
- pericarditis, which is inflammation of the sac around the heart
- mitral valve prolapse, which refers to a valve in the heart that is unable to close fully
- hypertrophic cardiomyopathy, which refers to
heart thickening that reduces the heart’s ability to pump blood - endocarditis, which is inflammation of the inner lining and valves of the heart
Some of these conditions may also cause other symptoms, such as edema, shortness of breath, a rapid heartbeat, dizziness, and lightheadedness.
Various lung conditions can cause chest pain.
In some cases, a person may experience chest pain only when breathing, coughing, sneezing, or moving the trunk. They may also experience more general symptoms such as dizziness, faintness, and shortness of breath when exercising.
In other cases, however, some lung conditions may cause sudden, severe chest pain and breathlessness that may require immediate medical attention.
Some lung-related problems of chest pain may include:
- pulmonary hypertension, which is high blood pressure in the arteries that carry blood to the lungs
- pleurisy, which is inflammation of the membrane that covers the lungs
- pulmonary embolism, which occurs when a blood clot gets trapped in an artery feeding blood to the lungs
- pneumothorax (collapsed lung), which occurs when air builds up in the space between the lungs and ribs
Several conditions that affect organs involved in digestion, such as the esophagus, may cause chest pain. In most cases, chest pain is not the primary symptom and may accompany other symptoms, such as:
- abdominal pain, swelling, bloating, or tenderness
- nausea and vomiting
- heartburn
- acid reflux
- regurgitation
Some conditions that may cause chest pain include:
- pancreatitis, which is an inflammation of the pancreas
esophageal contraction disorders , which are spasms or contractions in the food pipe- esophageal hypersensitivity, in which sensations that are not usually painful can cause severe pain
- esophageal rupture, which is when the
food pipe bursts , resulting in sudden, intense chest pain - peptic ulcers, which are sores in the
lining of the stomach - a hiatal hernia, which is when the stomach
pushes up into the chest - gastroesophageal reflux disease (GERD), which is a
chronic condition characterized by acid reflux causing heartburn
Several other conditions may cause chest pain, including:
- costochondritis, which is
inflammation of the cartilage of the rib cage - rib injuries, such as bruises or fractures, which may cause a cracking sound or extreme pain at the time of injury
A person should consider speaking with a healthcare professional if they experience chest pain that does not improve after a few days or worsens, and they experience other symptoms, such as:
- shortness of breath
- dizziness
- confusion
- fever
- nausea
- vomiting
- shaking or trembling
In some cases, chest pain can be life threatening. As such, a person should get immediate medical attention if they experience sudden, severe chest pain that radiates to other parts of the body, along with sweating, difficulty breathing, and loss of consciousness.
Sudden, severe chest pain may be serious. Other serious symptoms include pain spreading to the arms, back, neck, or jaw, shortness of breath, chest tightness, or pain accompanied by nausea, vomiting, and sweating.
Any person experiencing chest pain should consult a doctor.
Yes, it is possible for a person to have chest pain without a heart attack being the cause.
An electrocardiogram (ECG) can offer important information about possible narrowing of the coronary arteries, a heart attack, or an irregular heartbeat, such as atrial fibrillation. However, ECG results may be normal, even with serious heart conditions.
A normal ECG may be due to non-cardiovascular conditions, such as anxiety, or to conditions affecting the gastrointestinal tract, lungs, or muscles.
Four signs of an impending heart attack include:
- pain in the jaw, neck, or back
- lightheadedness or weakness
- pain in the arms or shoulders
- shortness of breath
People with these symptoms should seek immediate medical help.
Chest pain can happen 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.