Chest pain is a common symptom of severe cardiovascular and respiratory conditions, including heart attack and pulmonary embolism. However, chest pain also occurs as a result of less serious conditions, such as heartburn.
Waking up with chest pain can be frightening. In this article, we explore different causes of chest pain, the associated symptoms, and treatment options.
People may describe heart-related chest pain as a heaviness or tightness in the chest and upper back.
Types of heart-related chest pain include:
Angina is not a disease, but a symptom of CAD and coronary microvascular disease (MVD). It refers to chest pain or discomfort that occurs when the heart does not receive enough oxygen-rich blood.
Angina causes feelings of tightness, pressure, or heaviness in the chest. These symptoms may extend to the neck, jaw, arms, shoulders, and back.
2. Heart inflammation
Inflammation is the immune system’s natural response to disease, injury, and infection.
The types of heart inflammation include:
- Pericarditis: This refers to inflammation of the pericardium, which is the membrane that surrounds the heart.
- Myocarditis: This is inflammation of the heart muscle.
- Endocarditis: This causes inflammation of the endocardium, which lines the inside of the heart chambers and valves.
Symptoms vary depending on the type and location of heart inflammation.
Some people experience no symptoms while others report severe symptoms, such as:
- sharp, stabbing chest pain
- abnormal heartbeat or heart murmur
- difficulty breathing or shortness of breath
- signs of an infection, such as a fever or chills
- a persistent cough that may contain blood
- muscle or joint pain
- swelling of the legs or feet
3. Heart attack
A heart attack, also known as a myocardial infarction, occurs when the heart muscle is injured or dies because it does not receive enough oxygen-rich blood as a result of a blocked or ruptured coronary artery.
Symptoms of a heart attack include:
- chest pain or discomfort that can extend to the neck, arms, back, shoulders, or upper abdomen
- shortness of breath
- breaking out in a cold sweat
- sudden fatigue
According to the American Heart Association, males and females most commonly experience chest pain or discomfort as a heart attack symptom. However, women are more likely than males to experience some of the other symptoms, especially shortness of breath, and pain in the back or jaw.
If a person is experiencing symptoms of a heart attack, seek emergency medical help immediately.
Chest pain is one of the most common symptoms of respiratory disease. Respiratory issues can lead to chest pain that worsens with movement or changes in breathing.
Unlike heart-related chest pain, respiratory-related chest pain may affect either side of the chest as well as the diaphragm. People may describe the pain as a sharp, stabbing, or burning pain that occurs when they cough, inhale, or exhale.
Potential respiratory-related causes of chest pain include:
Viral and bacterial infections can lead to inflammation in the lung airways and tiny air sacs, known as alveoli.
In addition to chest pain, lung and chest infections can lead to:
- difficulty breathing
- shortness of breath
- coughing up yellow, green, or bloody mucus
Bronchospasm occurs when the muscles of the lung airways constrict and tighten, narrowing the diameter of the airways.
It can lead to pain or tightness in the chest, difficulty breathing, and sudden fatigue.
However, people who do not have any underlying respiratory conditions may experience exercise-induced bronchospasms (EIB). According to a 2018 article, EIB typically occurs 2-5 minutes after exercise and resolves within one hour.
6. Pulmonary hypertension
Symptoms of pulmonary hypertension include:
- chest pain
- rapid heartbeat
- shortness of breath
- loss of appetite
7. Pulmonary embolism
A pulmonary embolism is a severe and life-threatening condition that occurs when a blood clot forms in an artery to one of the lungs, starving the lung tissue of oxygen-rich blood.
It can cause pain in the chest or upper back. Other symptoms include pain, swelling, and redness in a leg, difficulty breathing, or coughing up blood.
Pneumothorax is typically known as a collapsed lung. It occurs when the air in the space between the lungs and chest wall puts pressure on a lung. This air prevents the lung from expanding, eventually leading to a partial or complete collapse of the lung.
People often experience sharp pain in the chest, sometimes just on one side.
Chest pain accompanied by an upset stomach, bloating, or nausea may indicate a digestive problem.
Gastroesophageal reflux disease (GERD) is a condition in which acid from the stomach flows backward into the esophagus. GERD can cause a burning sensation in the center of the chest.
Unlike cardiac and respiratory chest pain, heartburn pain typically remains localized and does not spread to other areas of the body.
People who have heartburn may also experience a sour taste in their mouth, difficulty swallowing, and bad breath.
10. Peptic ulcer
A peptic ulcer refers to an open sore on the lining of the stomach or small intestine that causes a burning sensation in the abdomen that may extend to the chest.
Peptic ulcers do not always cause symptoms. When symptoms do occur, they can include:
- nausea and vomiting
- dark, bloody stools
- loss of appetite
- unexplained weight loss
A person who experiences persistent chest pain accompanied by acid reflux or peptic ulcer symptoms may want to consult their doctor.
Other possible causes of chest pain include:
- Costochondritis: This is an inflammation of the cartilage that connects a rib to the sternum. Learn more about costochondritis here.
- Panic attack: This refers to the sudden onset of intense fear accompanied by chest pain, racing heartbeat, and dizziness. Learn more about chest pain and anxiety here.
- Injuries: Potential injuries may include bruised, fractured, or broken ribs
There are a variety of ways to diagnose chest pain.
A doctor will ask about a person’s medical history and perform a physical exam.
If they suspect that the cause is related to the heart, or respiratory system, they may perform a variety of diagnostic tests, such as blood tests and imaging tests.
If they suspect the cause is digestion-related, a gastroenterologist may perform additional tests, such as an upper gastrointestinal (GI) endoscopy.
Depending on the cause, a person may be able to ease chest pain at home. However, they should always see a doctor for advice first.
Treating heart-related chest pain
Treatments for heart-related chest pain vary depending on the underlying cause and severity of a person’s symptoms.
A doctor may prescribe medications, such as beta-blockers and cholesterol-lowering drugs.
According to the Centers for Disease Control and Prevention (CDC), lifestyle changes can help lower a person’s cholesterol levels and help to prevent future heart attacks.
Examples of heart-healthy lifestyle changes include:
- quitting tobacco smoking
- eating a heart-healthy diet that includes low-fat dairy products, lean proteins, and fish
- avoiding foods and drinks that contain trans fats, added sugars, and high levels of sodium
- exercising regularly
- losing excess body fat and maintaining a healthy weight
- avoiding excessive alcohol intake
Treating respiratory-related chest pain
Treatments for respiratory-related chest pain may include:
- dietary changes that help maintain a healthy weight
- medications that help regulate lung blood flow and blood pressure
- anticoagulant therapy to inhibit blood clots from forming
- inserting a chest tube to help drain air or fluid from around the lungs
- not smoking tobacco
Treating digestion-related chest pain
There are a variety of treatment options available to people who struggle with digestive health conditions.
Medications, such as H2 blockers, antacids, and proton pump inhibitors, help reduce the amount of acid in the stomach. These medications may help treat people with peptic ulcers and GERD.
A doctor may prescribe one or more antibiotics if a person has an ulcer caused by a specific bacterial infection.
Even if a heart attack is not the underlying cause, people must seek immediate medical attention if they experience:
- sudden, unexplained chest pain
- a crushing or constricting sensation on the breastbone and upper back
- chest pain that spreads to the arms, neck, jaw, or face
- chest pain accompanied by shortness of breath, dizziness, or nausea
Waking up with chest pain can be extremely upsetting. While chest pain is associated with heart attacks and other life-threatening conditions, pain may also occur due to minor issues, such as indigestion.
With that said, a person should always take chest pain seriously. People should contact their doctor if they experience sudden pain in one or both sides of the chest.