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Chest Pain
Introduction
Having chest pain can be scary. It does not always mean that you are having a heart
attack. There can be many other causes of chest pain, such as lung or digestive
problems. Chest pain can be a sign of a serious problem. If you experience chest pain,
you should always check with your healthcare provider.
This program discusses chest pain and its common causes. It also covers the
diagnosis and treatment of chest pain.
The Chest
The chest is the upper part of the torso, between the neck and abdomen. Many
organs, bones, and muscles are found in the chest. This section reviews anatomy of
the chest that you need to know to understand chest pain.
One of the main organs in the chest is the heart. The heart is
a highly specialized muscle. It is responsible for pumping
blood to all the organs in the body. The heart is enclosed in a
sac. This sac is called the pericardium. It helps the heart
work properly.
The aorta is the largest artery in the body. It carries oxygenrich blood away from the heart to blood vessels that reach
the rest of the body. The aorta starts at the top of the heart
and goes down behind the heart.
The other main organ in the chest is the lungs. The lungs fill
our blood with oxygen. Carbon dioxide also leaves the body through the lungs.
The esophagus is also in the chest. The esophagus is located behind the heart and
windpipe, which is also known as the trachea. The esophagus is the tube that takes
food from the mouth to the stomach. It is a part of the digestive tract.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 05/31/2016
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The chest also contains muscles, bones, and joints. Together, these form the chest
wall. Ribs are thin, curved bones that create a cage around the organs in the chest.
The ribs allow the lungs to expand and also protect the heart and lungs from being
damaged. A tough, flexible tissue called cartilage connects the ribs to the breastbone,
or sternum. The sternum is a long, flat bone that forms the front center of the chest
wall. The pleura is a membrane that lines the inside of the chest cavity. It also wraps
around the outside of the lungs.
Many problems can cause chest pain. There is no way to tell whether the pain is
caused by your heart or something else without seeing your healthcare provider. The
next four sections look at chest pain caused by heart, lung, digestive, and other
problems.
Heart-Related Chest Pain
Chest pain may be caused by problems with the heart. Sometimes the pain is better
described as discomfort rather than pain. Heart-related chest pain may also be
described as:
• Severe chest pain or pressure
• Crushing pain that may spread to the arms, neck, back,
and jaw area
• Pain that is prolonged, lasting anywhere from 30 minutes
to several hours
If chest pain is caused by a heart attack, resting often does not
help. Changing the position of the body does not relieve or
change the pain either. Some people feel indigestion and
nausea during a heart attack. This may be coupled with
sweating, dizziness, or shortness of breath.
Angina is pain in the chest and surrounding areas of the body. It happens when the
heart does not get enough oxygen. It is very important to seek treatment for angina. If
left untreated, it may result in a heart attack. A heart attack is an extreme, lifethreatening case of angina. Angina usually happens when a person exerts a lot of
physical effort for a few minutes. It usually goes away when the person rests or takes
medication. Sometimes it can happen at rest also.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 05/31/2016
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An aortic dissection can also cause chest pain. It is a life threatening condition. Aortic
dissection happens when the walls of the aorta become thin, balloon, and then rupture.
Pericarditis is an inflammation of the pericardium, or the sac that surrounds the heart. It
is often related to a viral infection and can cause chest pain.
Lung-Related Chest Pain
Many different lung disorders can cause chest pain. If chest pain is
caused by a lung problem, the pain often gets worse when you breathe
deeply, cough, or sneeze.
Lung problems that cause chest pain may also
cause other symptoms, including:
• Chest tightness
• Extreme tiredness
• Fever and chills
• Irregular or rapid heartbeat
• Shortness of breath
Some people with lung diseases that can cause chest pain also experience feelings of
anxiety or dread, light-headedness or fainting, and sweating.
One common cause of lung-related chest pain is pneumonia. Pneumonia is a common
infection in one or both lungs. Many germs, such as bacteria, viruses, and fungi, can
cause pneumonia.
Pleurisy can also cause chest pain. Pleurisy is a condition in which the pleura is
inflamed. The pleura is the membrane that lines the inside of the chest cavity. There
are many causes of pleurisy, but often it is the result of a viral infection.
A pulmonary embolism is a sudden blockage in a lung artery. The blockage is usually
caused by a blood clot that travels to the lung from a vein in the leg. It can be life
threatening and often causes severe chest pain.
If air leaks into the space between a lung and the ribs, it can cause the lung to
collapse. A collapsed lung can cause chest pain that starts suddenly and lasts for
several hours.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 05/31/2016
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Pulmonary hypertension may also cause chest pain. Pulmonary hypertension is high
blood pressure in the arteries of the lung.
Digestive-Related Chest Pain
Chest pain may be caused by problems with the digestive system. In some cases,
chest pain may be worse after eating if it is caused by a digestive problem. Most
digestive problems that can cause chest pain also cause other symptoms. Some of
these symptoms include:
• Burning in the chest
• Difficulty swallowing
• Nausea or vomiting
• Pain in the back between the shoulder blades
• Pain under the right shoulder
• Steady pain in the upper abdomen
A common digestive-related cause of chest pain is
heartburn. Heartburn is a painful burning feeling in your
chest and throat. It happens when stomach acid backs
up into the esophagus. Almost everyone experiences heartburn at some point in their
life. Swallowing disorders can also be a cause of chest pain. Problems with the
esophagus can make swallowing difficult and painful.
Problems with the gallbladder and pancreas can also cause chest pain, even though
these organs are not in the chest. The gallbladder and pancreas are located in the
upper abdomen. Inflammation of these organs can cause pain in the abdomen that
sometimes spreads to the chest.
Other Causes of Chest Pain
Sometimes chest pain may be caused by problems with the
muscles or bones in the chest. For example, sore muscles and
injured ribs may cause chest pain.
Costochondritis is a condition in which the cartilage in the rib
cage becomes swollen and inflamed. It can also cause chest
pain that may feel like a heart attack.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 05/31/2016
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People who experience panic attacks may also have chest pain. Panic attacks are
sudden feelings of terror for no reason and can cause:
• Fast heartbeat
• Chest pain
• Breathing difficulty
• Dizziness
The symptoms of a panic attack are similar to the symptoms of a
heart attack. It can be difficult to tell which is causing your
symptoms. Seek emergency medical advice.
Shingles is a disease caused by the same virus that causes
chickenpox. The virus stays in your body after you have chickenpox and may reappear
as shingles later in life. Shingles may cause a band of blisters on the back and chest,
as well as chest pain.
When to See a Doctor
Seek emergency medical advice if you have chest pain or pressure that:
• Is new or different
• Lasts longer than 2 to 3 minutes
• Leaves and then returns
Always treat chest pain seriously. Even if the chest pain
is not related to a heart attack, it is better to be safe and
be checked by a healthcare provider. Other causes of
chest pain may also need immediate treatment to
prevent complications.
Diagnosis
Your healthcare provider will ask about your medical history and symptoms. You will
also be asked about the medications you are currently taking. A physical exam will also
be done. With chest pain, healthcare providers first want to check the heart. An
electrocardiogram, or ECG, records the electrical activity of the heart. It can show
whether a heart attack is in progress or has already happened.
Healthcare providers also want to check for life threatening lung conditions. A chest xray can show the size and shape of the heart and lungs. It can also show lung
problems, such as pneumonia or a collapsed lung.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 05/31/2016
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Other imaging tests may be done to look at the organs and structures in the chest
more closely. These include a CT scan or MRI. A CT scan is an x-ray machine linked
to a computer. A CT scan takes a series of detailed pictures of your organs. You may
be given contrast material by mouth or injection to make abnormal areas easier to see.
An MRI uses strong magnets to create images of the inside of the body.
Blood tests may be done. Depending on the results of the tests, your healthcare
provider may order other tests to diagnose or rule out problems.
After the cause of your chest pain has been diagnosed, your healthcare provider may
recommend different treatments. Treatment for chest pain depends on the cause.
Summary
When you experience pain in your chest, it can be scary.
It does not always mean that you are having a heart
attack. There can be many other causes of chest pain,
such as lung or digestive problems.
Even when it is not caused by a heart attack, chest pain
can be a sign of a serious problem. You should seek
emergency medical advice if you have chest pain or
pressure that:
• Is new or different
• Lasts longer than 2 to 3 minutes
• Leaves and then returns
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 05/31/2016
syf10101
6