Chest pain appears in many forms, ranging from a sharp stab to a dull ache. Sometimes chest pain feels crushing or burning. In certain cases, the pain travels up the neck, into the jaw, and then spreads to the back or down one or both arms.
Many different problems can cause chest pain. The most life-threatening causes involve the heart or lungs. Because chest pain can indicate a serious problem, it's important to seek immediate medical help.
Chest pain can cause many different sensations depending on what's triggering the symptom. Often, the cause has nothing to do with the heart — though there's no easy way to tell without seeing a health care provider.
Heart-related chest pain
Although chest pain is often associated with heart disease, many people with heart disease say they have a vague discomfort that isn't necessarily identified as pain. In general, chest discomfort related to a heart attack or another heart problem may be described by or associated with one or more of the following:
- Pressure, fullness, burning or tightness in your chest
- Crushing or searing pain that spreads to your back, neck, jaw, shoulders, and one or both arms
- Pain that lasts more than a few minutes, gets worse with activity, goes away and comes back, or varies in intensity
- Shortness of breath
- Cold sweats
- Dizziness or weakness
- Nausea or vomiting
Other types of chest pain
It can be difficult to distinguish heart-related chest pain from other types of chest pain. However, chest pain that is less likely due to a heart problem is more often associated with:
- A sour taste or a sensation of food reentering your mouth
- Trouble swallowing
- Pain that gets better or worse when you change your body position
- Pain that gets worse when you breathe deeply or cough
- Tenderness when you push on your chest
- Pain that persists for many hours
The classic symptoms of heartburn — a painful, burning sensation behind the breastbone — can be caused by problems with the heart or the stomach.
When to see a doctor
If you have new or unexplained chest pain or think you're having a heart attack, call 911 or emergency medical assistance immediately. Don't ignore the symptoms of a heart attack. If you can't get an ambulance or emergency vehicle to come to you, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only if you have no other option.
Chest pain has many possible causes, all of which need medical attention.
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.
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.
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.
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.
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.