Electrocardiogram (ECG)

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Chest Pain: What You Need to Know

Causes of chest pain

When you experience chest pain, it can feel like your world is ending. The intensity itself is often enough to send anyone into a panic. However, pain in the chest doesn’t always indicate a heart attack or other serious condition. Often, it is a result of something much less concerning. Here are some things you should know about this condition and what to do if you experience it.

What is chest pain?

It can be described as any pain in the area of your chest. For some people, it is in the middle of the chest, while for others it is on one of the sides of the chest. At times, it can be accompanied by a feeling of pressure, tightness, heaviness, or burning.


The source can be on many different areas of the chest. It can originate in the heart, lungs, or blood vessels. Chest pain may be short-term (acute), or long-lasting (chronic). It can also radiate to the jaw and arm or through to the back. 

What Causes Chest Pain

There are many possible causes. Some of the most common ones include: 

  • Chest infection (bacterial or viral) – People who have recently been sick with a viral or bacterial infection are at risk for developing it. Chest infections can cause this in the area of the lungs, which can cause pain in the chest. Sometimes, it feels worse with deep breathing. 
  • Chest wall pain – A condition that is caused by an injury to the ribs, muscles, or cartilage in the chest wall is another possible reason of what causes chest pain.
  • Heartburn – When you have overeaten or consumed a large quantity of spicy or acidic foods. Heartburn can occur when the acid in your stomach refluxes into the esophagus. It can sometimes be felt in the chest.
  • Inflammation of the inner lining of the heart (pericarditis) – An infection of the heart lining (pericardium) can cause inflammation of the inner lining of the heart and is a contributing factor of what causes chest pain.
  • Coronary artery disease (angina) – In this condition, the arteries supplying the heart with blood are narrowed. This usually becomes of reason of what causes chest pain on exertion. 
  • Heart attack (myocardial infraction) – A fatty plaque in the heart arteries gets inflamed and ruptures causing a clot to form in the artery. This is a medical emergency. 

When should you be concerned?

If it is new, or you have other symptoms alongside it, you should see your doctor. The type of pain and other symptoms you have can help determine its cause. For example, if you have heavy pain in your chest, accompanied by nausea and dizziness, it could be a sign of a heart attack.



Pain that happens along with shortness of breath can be a sign of a respiratory infection. Burning pain in your chest along with fatigue and indigestion is a sign of heartburn.  If in doubt, call an ambulance and seek help immediately.

Chest Pain: What You Need to Know

Other common causes

  • Arthritis – Arthritis in the ribs can be one of its causes.
  • Rib fracture – A fracture of the ribs can cause it. It can last for a long time and worsen with coughing and breathing.
  • Anxiety – An anxiety attack can cause a feeling of tightness in the chest.
  • Costochondritis – It can be caused by an inflammation of the joints connecting the ribs to the breastbone.
  • Stress – A lot of stress can cause tension in the chest.
  • Sprain – A sudden movement that stretches or tears the muscles or ligaments in your chest.
  • Heart palpitations – A feeling of irregular or fast beating of the heart.

More serious causes

  • Aortic dissection – A tear in the wall of the main artery that carries blood from the heart to the rest of the body.
  • Coronary artery disease  A disease that affects the blood vessels supplying the heart.
  • Myocardial infraction (heart attack) – A sudden loss of blood flow to part of the heart, which results in chest pain, shortness of breath, and nausea.
  • Pulmonary embolus – A blood clot that forms in the lungs, blocking blood vessels.

Left Chest Pain

Left chest pain can be a troubling sign for many people, prompting immediate concerns about heart health. However, the reasons for chest pain, particularly on the left side, are many, ranging from minor muscular strains to life-threatening heart problems. Understanding the many causes of left chest pain is critical for determining the best course of action and therapy.


Reasons for Chest Pain: A Focus on the Left Side


1. Cardiac Causes

Cardiac disorders are one of the most serious causes of left chest pain. Coronary artery disease (angina), acute myocardial infarction (heart attack), and other cardiac disorders such as myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the heart’s outer membrane) can all become reasons for chest pain. These diseases are frequently accompanied by other symptoms like palpitations, shortness of breath, and dizziness.


2. Gastrointestinal Factors

The digestive system can also become one of the reasons for chest pain. Gastroesophageal reflux disease (GERD), peptic ulcers, and hiatal hernias can all elicit symptoms similar to cardiac left chest pain, causing confusion and worry. These diseases are frequently associated with meals, certain foods, or lying down after eating.


3. Musculoskeletal Issues

Common physical reasons for chest pain include muscular strains, rib injuries, and costochondritis (rib cartilage inflammation). This sort of discomfort is usually confined and might be worsened by certain motions or pressure on the affected area.


4. Pulmonary Conditions

Pneumonia, pleurisy, pulmonary embolism, and pneumothorax can all cause intense, stabbing chest pain, which is frequently accompanied by difficulty breathing, coughing, or fever.


5. Psychological Causes

Anxiety and panic disorders is another of the several reasons for chest pain and is similar to that of a heart attack, including a rapid heartbeat and shortness of breath. Recognizing the psychological causes of chest pain is critical to effectively managing panic and anxiety crises.


When Should I Seek Urgent Medical Attention for Left Chest Pain


Certain aspects of left chest discomfort require a prompt medical evaluation:

  • Intense, Crushing Pain: Severe pain, especially if it spreads to the jaw, arm, or back, may suggest a heart attack.
  • Breathing Difficulties: Sudden shortness of breath, along with chest pain, requires immediate medical attention owing to possible heart or lung problems.
  • Accompanying Symptoms: Chest pain combined with nausea, sweating, or fainting may indicate a cardiac episode.
  • Sudden Onset: Pain that develops unexpectedly and intensely should be treated carefully and evaluated immediately.

Different Types of Heart Pain

Types of heart pain can be severe and searing, or dull and achy. It is critical to distinguish between different types of heart discomfort because some may be signs of a more serious illness. If you have any form of heart pain, you should seek medical assistance immediately.

Angina: How it Feels and Its Implications

Heart pain, also known as angina pectoris, is a sign of an underlying heart problem that typically indicates that a portion of the heart is not receiving enough oxygen. Understanding the various types of heart pain is critical since they can provide valuable insights into the nature of cardiac disorders that may be encountered, guiding both diagnosis and treatment. This section goes into the numerous types of heart pain, discussing their characteristics, causes, and implications for heart health.

Stable Angina

Stable angina is the most common type of heart pain, which is usually caused by physical exertion or emotional stress. It occurs when the heart muscle needs more oxygen than the constricted coronary arteries can provide. The pain is typically described as a pressure or tightness in the chest, which may spread to the arms, neck, jaw, and back. Stable angina is predictable in nature, occurring at similar degrees of effort and improving with rest or medicine such as nitroglycerin.

Unstable Angina

Unstable angina is a more dangerous condition that indicates a potential heart attack. Unlike stable angina, it can strike suddenly, even at rest, and its severity and frequency can fluctuate. The pain is worse and lasts longer than with stable angina. Unstable angina demands prompt medical attention because it suggests that a coronary artery may be blocked, severely reducing blood supply to the heart.

Variant (Prinzmetal’s) Angina

Variant or Prinzmetal’s angina is a rare form that causes brief spasms in the coronary arteries, narrowing them and reducing blood flow to the heart muscle even when plaques are not present. This type of angina typically happens at rest and during the night or early morning hours. The pain can be intense, but most episodes can be eased with medication.

Microvascular Angina

Microvascular angina, also known as Cardiac Syndrome X, is pain caused by anomalies in the tiny coronary artery blood vessels (microvasculature) that are not visible on ordinary angiograms. This type of angina may indicate endothelial dysfunction or small vessel disease, in which the smaller arteries fail to supply the heart muscle with sufficient oxygen-rich blood. This illness can be chronic and may not respond well to conventional angina treatment.

Understanding the Symptoms

While chest/heart pain is the characteristic of angina, the sensations and symptoms can vary greatly between people. Some may feel a sense of fullness, squeezing, or a heavy weight on their chest. Others may refer to it as indigestion or heartburn. Shortness of breath, dizziness, nausea, and acute exhaustion can all accompany heart pain, therefore it’s important to detect these variations.

Key Takeaways

Differentiating between types of heart pain is critical for quick and effective treatment. Stable angina, albeit less severe, indicates the need for lifestyle adjustments and maybe medication to manage symptoms and avoid further deterioration. Unstable angina and Variant angina are medical crises that require rapid treatment to avoid potentially fatal effects. Microvascular angina emphasizes the complexities of heart disease and the importance of thorough diagnostic approaches.
Recognizing the symptoms and types of heart pain can help you seek medical assistance in a timely manner, thereby avoiding major cardiac events. As science evolves, the medical community improves diagnostic methods and treatment choices, providing hope to patients suffering from heart pain and other related illnesses.

What Causes Chest Pain in Women?

Women’s chest pain can be caused by a range of circumstances, including benign diseases and more significant health difficulties. While some factors are identical to those in men, there are specific concerns and situations that are more prevalent or manifest differently in women. The following are some prevalent reasons of chest pain in women:

1. Cardiac Causes

  • Coronary Artery Disease (CAD): Although CAD is more commonly associated with men, it is a significant source of chest pain and the top cause of death among women. Women may suffer more modest symptoms than men, such as soreness, heaviness, or a burning sensation, rather than acute chest pain.
  • Microvascular Coronary Dysfunction: Women are more prone than men to experience chest pain as a result of microvascular coronary dysfunction, which occurs when smaller coronary arteries do not function effectively despite the fact that bigger arteries are free of atherosclerosis.
  • Myocardial infarction (Heart Attack): Women may experience different heart attack symptoms than men, such as nausea, vomiting, back or jaw pain, and shortness of breath, in addition to or instead of chest pain.
  • Pericarditis: An inflammation of the tissue surrounding the heart, which can produce intense chest pain that worsens when breathing or lying down.

2. Gastrointestinal Causes

  • Gastroesophageal Reflux Disease (GERD): Symptoms include a burning sensation in the chest or upper abdomen, which can be misinterpreted for heart trouble.
  • Gallbladder Disease: Specifically, gallstones can produce a severe discomfort in the upper right abdomen that radiates into the chest.
  • Peptic Ulcers: Sores on the stomach or small intestinal lining can cause burning or gnawing pain in the belly, which may be mistaken for chest pain.

3. Musculoskeletal Causes

  • Costochondritis: An inflammation of the cartilage where the ribs join to the sternum, resulting in localized chest wall pain, particularly when palpating the area.
  • Fibromyalgia: Fibromyalgia is an illness marked by widespread musculoskeletal discomfort that can affect the chest area.

4. Pulmonary Causes

  • Pulmonary Embolism: A blood clot in the lungs that can cause severe chest pain, loss of breath, and potentially fatal complications.
  • Pneumonia or Pleurisy: An infection or inflammation of the lungs and adjacent tissues can cause chest pain, particularly while taking heavy breaths.

5. Psychological Causes

  • Panic attacks and anxiety can cause symptoms similar to a heart attack, such as chest discomfort, rapid heartbeat, and shortness of breath.

6. Breast Condition

  • Mastitis, cysts, and transferred pain from breast tissue can all present as chest pain.

7. Hormonal Fluctuations

  • Some women suffer chest discomfort caused by hormonal changes, especially during periods of considerable hormonal fluctuation such as menstruation, pregnancy, or menopause.

8. Other Causes

  • Other causes include herpes zoster (shingles), which can cause a painful rash on the chest or back, and some types of cancer, which, while less common, can cause chest pain.
Women suffering chest discomfort, especially if it is sudden, intense, or accompanied by symptoms such as shortness of breath, nausea, or dizziness, should seek medical assistance right once to rule out potentially fatal diseases. Heart disease and other illnesses can show differently in women, making early detection and treatment crucial.

What To Do If You Have Chest Pain: Immediate Steps and Considerations

Given its potential link to heart problems, chest pain can be worrisome. However, the reasons of chest pain range from benign to catastrophic. Knowing what to do if you have chest pain is critical for controlling the situation and protecting your health and safety. Here’s a quick overview of the measures to follow and concerns to keep in mind.

Initial Steps to Take

1. Keep Calm: Panic can worsen the problem. Take long, steady breaths to settle your nerves and examine your situation.

2. Stop Any Physical Activity: If the discomfort begins while exercising, stop immediately and rest. Overexertion can put strain on the heart, especially if the chest pain is caused by a cardiac condition.

3. Assess the Pain: Determine the nature of the pain. Is it sharp or blunt? Is it localized or widespread? Does it worsen with deep breathing or movement? This information can be useful to medical experts.

4. Take Medication as Prescribed: If you have a known heart issue and have been prescribed medication such as nitroglycerin, begin taking it as soon as symptoms appear.

5. Seek Medical Attention: If the pain is severe, unexplained, or accompanied by symptoms such as shortness of breath, dizziness, or nausea, contact emergency services or visit the nearest emergency room. Do not attempt to drive yourself.


Considerations and Precautions

  • Don’t Ignore the Pain: Although not all chest pain indicates a heart attack, it’s critical not to overlook severe or unusual chest discomfort. It’s preferable to err on the side of caution and get medical help.
  • Be Aware of Heart Attack Symptoms: In addition to chest pain, a heart attack can cause discomfort in other parts of the upper body, shortness of breath, cold perspiration, nausea, or lightheadedness.
  • Don’t Delay: Time is of the essence, especially if the chest pain is related to the heart. Prompt therapy can help save lives and reduce heart damage.
  • Avoid Self-Diagnosis: While it may be tempting to self-diagnose based on symptoms, only a healthcare expert can accurately determine the reason of chest discomfort using diagnostic testing and examination.
  • Follow Up: Even if your chest pain fades and you decide not to seek emergency care, you should contact your healthcare practitioner to describe the occurrence and maybe undergo an evaluation to establish the cause.
It’s important to know what to do if you have chest pain. On its onset, it is crucial that you employ a cautious approach, beginning with discontinuing any vigorous activity and determining the nature of the problem. It is critical to take any prescribed medication and seek emergency medical assistance if the symptoms are severe, persistent, or accompanied by additional concerns. 
Remember that when it comes to chest pain, it is always preferable to be overly cautious than to ignore a possibly serious problem. Regular follow-ups with a healthcare specialist can also assist address any underlying concerns causing chest pain, guaranteeing long-term health.

Frequently Asked Questions


Q: What is sore chest and should I be concerned if I experience it?
A: A sore chest can be due to minor issues like muscle strain or serious conditions like heart or lung problems. If the soreness is severe, persistent, or accompanied by other concerning symptoms, it’s important to seek medical attention to ensure it’s not something more serious.



Q: What is thorax pain?
A: Thorax pain refers to discomfort or pain in the chest area, which can stem from various causes, ranging from musculoskeletal issues to heart and lung conditions. It warrants medical evaluation if persistent or severe.



Q: Is chest pain normal when I’m exercising?

A: Mild chest pain during exercise is common, especially in those who are new to physical activity, but considerable or chronic pain is abnormal and should be assessed by a healthcare expert.


Q: Is it normal to feel left chest pain when breathing?

A: Feeling left chest pain while breathing is not typical and may suggest pleurisy or a musculoskeletal issue. It is best to consult a healthcare expert for a precise diagnosis.


Bottom line


Chest pain is a common symptom that can be caused by various diseases. It can also be a symptom of anxiety, stress, or heart palpitations. If you are experiencing chest pain, it is important to see a doctor to find out the cause and how to treat it. You should also make sure that you know what the warning signs of a heart attack are, so you can seek medical attention as soon as possible if you experience them.



Thankfully, there are several ways how you can manage stress and improve your heart’s health that doesn’t require much expense. You can incorporate healthy practices into your daily routine in order to prevent further problems. Learning to manage sleep, reduce stress, and an active lifestyle really helps but seeing your cardiologist on a regular basis still is a must.



Written by: Dr Michael MacDonald MB ChB, BSc (Hons), MRCP (UK), MD (Research), FESC (Europe).  Dr MacDonald was trained in the UK and is a senior Consultant Cardiologist. Updated 20 August 2

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