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What causes chest pain?

Linda Martinez
Cardiac Rehabilitation Specialist

Many things can cause chest pain. Depending on the nature, duration and timing of the pain, it can be from the heart, esophagus, stomach, lungs or even the muscles and bones of the rib cage. If you are having chest pain, it should be evaluated by a physician to determine the cause. It should not be ignored to be safe.

Dr. Kathleen Handal, MD
Emergency Medicine Specialist

Discomfort described as 'pain' in the chest area can have many possible causes. Always think of a possible heart attack first. Lung infections (pneumonia), bronchitis, asthma, blood clots or a collapsed lung can all cause pain in the chest area. Trauma to the chest can fracture ribs and/or cause damage to underlying organs. Care at a recognized chest pain center hospital can make a difference.

Many different problems can cause chest pain. The chest is a sort of “big box” that contains many different organs and structures that can trigger the “alarm system” in the form of pain. Organs and structures in the chest include the chest wall, bones, muscles, nerves, large and smaller blood vessels, the skin, the lungs, the heart and the esophagus. Many times some chest discomfort may come from nearby organs such as the liver, gallbladder, pancreas or stomach. The most life-threatening and time sensitive problems that can cause chest pain involve the heart, the aorta (a large blood vessel) or the lungs. Because it can be difficult to determine the exact cause of chest pain, it's best to seek immediate medical help in the form of a simple consult or emergency evaluation.

When blood flow to the heart muscle is reduced, people experience chest pain. This reduced blood flow usually is caused by coronary heart disease.

Your chest pain may come and go for no known reason. Some chest pain may return often and be bothersome to you, but it may not be dangerous. Some chest pain may be a sign of a serious health condition. You may not know what is causing your chest pain until you are seen at a hospital or clinic. Some causes of chest pain include the following:

  • Blood or circulation problems: High blood pressure or anemia (iron-poor blood) may cause chest pain. Another cause may be an aneurysm, which is a weak part in an artery (blood vessel) wall. Aneurysms can be life-threatening. Atherosclerosis may cause chest pain. This is a disease that causes fatty deposits to narrow arteries in your body, increasing your risk of blood clots.
  • Heart (cardiac) problems: Chest pain because of a heart problem may be life-threatening and requires emergency medical care. Only a healthcare provider can say for sure if your chest pain is caused by a heart problem or not.
  • Anxiety, depression or panic attacks: Panic attacks may cause chest pain that feels like you have a serious health problem, even though it is not life-threatening. Hyperventilation (breathing too fast) can also cause bad chest pain. People who have depression may have chest pain or heaviness.
  • Bone, nerve or muscle problems: Examples include arthritis and other inflammation (swelling) problems, hard coughing and overdoing exercise. Herpes zoster (shingles) can cause chest pain. Injuries, such as from a car accident or a blow to the chest, may also cause chest pain.
  • Lung problems: Examples include infections (such as bronchitis), or inflammation in or around a lung. A blood clot in a lung or lung diseases may cause chest pain. Smoke or fumes can cause chest pain.
  • Digestive tract problems: Acid reflux, ulcers or other stomach and throat problems may cause chest pain. Problems with too much gas in your stomach or intestines, or other digestion problems may cause chest pain. Gallbladder or pancreas problems may also cause chest pain.
  • Other problems: Illegal drugs, such as cocaine, can cause chest pain. You may have chest pain if you misuse certain medicines. Diseases such as lupus, and tumors (growths) in your chest or abdomen may cause chest pain.
There are many possible causes of chest pain, some of which are serious and life threatening, and some that are not. It can be difficult to determine the exact cause of chest pain, and so it’s best to seek immediate medical help if you’re experiencing it.

Chest pain can be caused by many things, in addition to the heart: It can be caused by bone issues (including ribs and sternum), organs such as the lungs (as well as airways) and even entire systems in the body, such as the gastrointestinal system. Cardiac pain is called angina pectoris.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.