Chest pain has many possible causes, all of which need medical attention. A few are discussed below.
Heart-related causes
Examples of heart-related causes of chest pain include:
- Heart attack. A heart attack results from blocked blood flow, often from a blood clot, to the heart muscle.
- Angina. Angina is the term for chest pain caused by poor blood flow to the heart. This is often caused by the buildup of thick plaques on the inner walls of the arteries that carry blood to the heart. These plaques narrow the arteries and restrict the heart’s blood supply, particularly during physical activity.
- Aortic dissection. This life-threatening condition involves the main artery leading from the heart (aorta). If the inner layers of this blood vessel separate, blood is forced between the layers and can cause the aorta to rupture.
- Inflammation of the sac around the heart (pericarditis). This condition usually causes sharp pain that gets worse when breathing in or lying down.
Digestive causes
Chest pain can be caused by disorders of the digestive system, including:
- Heartburn. This painful, burning sensation behind the breastbone occurs when stomach acid washes up from the stomach into the tube that connects the throat to the stomach (esophagus).
- Swallowing disorders. Disorders of the esophagus can make swallowing difficult and even painful.
- Gallbladder or pancreas problems. Gallstones or inflammation of the gallbladder or pancreas can cause abdominal pain that spreads to the chest.
- Peptic ulcers. Peptic ulcers are sores in the stomach lining. They can cause pain in the abdomen or upper abdomen after eating, bloating, nausea and vomiting possibly with blood. They do not usually cause intense pain but can result in a recurring discomfort in the chest.
Muscle and bone causes
Some types of chest pain are associated with injuries and other problems affecting the structures that make up the chest wall, including:
- Costochondritis. In this condition, the cartilage of the rib cage, particularly the cartilage that joins the ribs to the breastbone, becomes inflamed and painful.
- Sore muscles. Chronic pain syndromes, such as fibromyalgia, can cause persistent muscle-related chest pain.
- Injured ribs. A bruised or broken rib can cause chest pain.
Lung-related causes
Many lung disorders can cause chest pain, including:
- Blood clot in the lung (pulmonary embolism). A blood clot that gets stuck in a lung (pulmonary) artery can block blood flow to lung tissue.
- Inflammation of the membrane covering the lungs (pleurisy). This condition can cause chest pain that worsens when you inhale or cough.
- Collapsed lung. The chest pain associated with a collapsed lung typically begins suddenly and can last for hours and is generally associated with shortness of breath. A collapsed lung occurs when air leaks into the space between the lung and the ribs.
- High blood pressure in the lung arteries (pulmonary hypertension). This condition affects the arteries carrying blood to the lungs and can produce chest pain.
- 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 persistent pain or pressure in the chest, breathing difficulty, blue lips or nails, new confusion and difficulty staying awake
- Tuberculosis (TB). Tuberculosis is a bacterial infection that usually affects the lungs. It can cause chest pain, a bad cough which may produce blood or sputum, weight loss, a fever and night sweats. In the past, TB was nearly always fatal. Nowadays, antibiotics can usually treat it successfully.
- Asthma. Asthma is a common breathing disorder characterized by inflammation in the airways, which can cause chest pain. Other symptoms include tightness in the chest, shortness of breath, coughing and wheezing
Other causes
Chest pain can also be caused by:
- Panic attack. If you have periods of intense fear accompanied by chest pain, a rapid heartbeat, rapid breathing, profuse sweating, shortness of breath, nausea, dizziness and a fear of dying, you may be having a panic attack.
- Shingles. Caused by a reactivation of the chickenpox virus, shingles can produce pain and a band of blisters from the back around to the chest wall.
- 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: lying down, doing exercise, breathing deeply, coughing or sneezing