Chest pain when lying down can be a symptom of problems with the heart, respiratory system, or digestive system. Though most causes are not serious, chest pain can indicate a life threatening health issue, so it is best to check with a healthcare professional as soon as possible.

Chest pain can be a symptom of several potentially life threatening conditions, but other causes may not be so serious. Some common conditions that can cause chest pain include:

  • angina
  • pericarditis
  • chest or lung infection
  • anxiety

This article covers the possible causes of chest pain when lying down, their symptoms, treatments, and when to contact a doctor.

A person lying down on a bed and with their hand on their chest. There are several causes of chest pain when lying down.Share on Pinterest
laflor/Getty Images

Heart failure occurs when the heart cannot pump enough blood around the body. This is usually a result of the heart muscles becoming too weak or stiff.

Symptoms

People with heart failure typically present with the following symptoms:

Treatment

Heart failure treatment involves managing symptoms to prevent a cardiac event. This is mainly achieved through medication and lifestyle changes.

Lifestyle changes include:

  • maintaining a moderate weight
  • eating a balanced diet
  • stopping smoking
  • getting moderate exercise

Medications include:

Gastroesophageal reflux disease (GERD) is a chronic digestive disorder that occurs when acidic stomach contents flow back into the esophagus. It can present as either erosive or non-erosive.

Symptoms

Common symptoms of GERD include:

A person with GERD may also experience worse symptoms when lying down too soon after eating.

Treatment

The treatment of GERD usually aims to address symptoms and prevent complications. This often includes lifestyle changes in addition to medication.

Lifestyle changes include:

  • maintaining a moderate weight
  • maintaining good sleep hygiene
  • reducing alcohol consumption
  • not lying down within 2–3 hours of eating
  • elevating the head of the bed 6–8 inches

Medications include:

Surgical interventions include:

  • laparoscopic Nissen fundoplication
  • laparoscopic anterior 180-degree fundoplication
  • bariatric surgery

Anxiety disorders are a group of related conditions characterized by excessive and persistent fear or worry. Anxiety disorders share similar symptoms, although symptoms for specific disorders also differ.

Symptoms

An individual with an anxiety disorder may experience one or more of the following symptoms:

  • restlessness or irritability
  • fatigue
  • feelings of apprehension or dread
  • shortness of breath
  • racing heart
  • headaches and muscle aches
  • insomnia
  • difficulty controlling feelings of worry

People who experience panic disorder, an anxiety disorder that causes panic attacks and sudden feelings of terror, may also experience:

These symptoms can sometimes be mistaken for a heart attack.

Learn more about symptoms and causes of anxiety and chest pain.

Treatment

Treatment options for anxiety disorders differ based on the type. However, some common types of treatment include:

Costochondritis is inflammation of the costal cartilage — the cartilage that joins the ribs to the sternum. It can occur due to injury, repetitive upper-body movements, such as lifting weights, and infection.

Symptoms

People with costochondritis usually present with sharp or dull pain in the front or side of the chest. The pain can worsen when a person is lying down, and through movement and deep breathing.

Since chest pain is the primary symptom of costochondritis, healthcare professionals will exclude other conditions by taking a medical history and performing a physical exam. On examination, doctors can reproduce the pain by applying direct pressure to the chest wall.

Learn more about sharp stabbing pains in the chest that come and go.

Treatment

Costochondritis may resolve on its own in some cases. Otherwise, a person may take nonsteroidal anti-inflammatory drugs (NSAIDs), such as:

In more severe cases, a doctor may suggest a combination of steroid injections and local anesthetic to help relieve pain.

Angina is a type of chest pain caused by reduced blood flow to the heart muscles. This is due to the blood vessels becoming blocked, which is typically a symptom of coronary heart disease. Often, physical exertion triggers angina.

Angina is not usually life threatening. However, it can be a warning sign of a stroke or heart attack.

Symptoms

Some common symptoms of angina include:

These symptoms may be accompanied by:

Treatment

The treatment of angina is usually aimed at managing symptoms and slowing its progression to a cardiac event such as a heart attack or stroke.

Treatment options include medications and lifestyle modifications.

Medications may include:

Lifestyle modifications can include:

A healthcare professional may suggest surgical intervention if lifestyle changes and medications are insufficient.

Pericarditis is the swelling and inflammation of the pericardial sac — a thin tissue surrounding the heart.

Symptoms

Common symptoms of pericarditis include:

  • a central, sharp chest pain
  • pain that feels worse when breathing deeply and is improved by sitting up and leaning forward
  • pain that may radiate to the neck and shoulders

Pericarditis can be a symptom of other conditions, such as an infection. Thus, other symptoms may accompany the condition, such as:

Treatment

There are several treatment options for pericarditis, depending on the cause of the condition and its severity. The most common ones include the following:

In more severe cases, an individual may undergo surgery to treat pericarditis.

Other possible and less common causes of chest pain include:

It is best to seek medical help if chest pain comes on suddenly and with little to no relief from anti-inflammatory painkillers.

Some signs to seek emergency medical care include:

  • pain radiating to the back, neck, and jaw
  • pain lasting more than 15 minutes
  • the chest feeling tight and heavy
  • feeling nauseous and vomiting
  • excessive sweating
  • having blue lips or fingertips

These symptoms could indicate that a person is having a heart attack, so it is important to seek medical care immediately.

Learn more about recognizing the signs of a heart attack and what to do.

Chest pain when lying down can be a symptom of various conditions. Usually, accompanying symptoms and a checkup by a healthcare professional can provide more information on why an individual may be experiencing chest pain.

Most causes of chest pain are not life threatening, but a person with chest pain should seek urgent medical attention to rule out serious health issues, particularly if the pain radiates to other parts of the body and they have trouble breathing.