Chest Pain: Different Causes and How to Differentiate

By Dr. Naveen Bhamri in Cardiac Sciences

Mar 22 , 2023 | 2 min read

What is chest pain?

Chest pain is like a sharp, excruciating pain around the chest. It may level down to your arms or towards your neck or jaw. Most patients feel tightness and pressure in the chest that also feels like something is crushing the chest. This may be felt for a few minutes to a few hours or months.

What causes chest pain?

When you have chest pain, you link it to a heart attack. However, there are other less severe causes of chest pain than heart attack; they can be muscle-related, stomach related or lung related.

Heart-related causes of chest pain

The following are termed heart-related causes of chest pain:

  • Heart attack: When the supply of blood to the arteries is compromised, it leads to a heart attack, and the most common sign is chest pain.
  • Angina: This is caused by a blockage in the blood vessels that connect to the heart, causing severe chest pain.
  • Pericarditis: It is the inflammation in the tissues surrounding the heart. This condition can be mild or life-threatening if not treated on time.
  • Myocarditis: This is mostly caused by a viral infection that leads to inflammation of the heart muscles. This inflammation reduces the ability of the heart to pump blood and can lead to severe chest pain.
  • Cardiomyopathy: This is a disease of the heart muscles that makes it difficult for the heart to pump blood.
  • Aortic dissection: An aortic dissection is a serious condition in which a tear occurs in the inner layer of the body's main artery (aorta). Blood rushes through the tear, causing the inner and middle layers of the aorta to split (dissect). If the blood goes through the outside aortic wall, aortic dissection is often deadly.

Gastrointestinal causes of chest pain

  • Heartburn or acid reflux: It appears as discomfort or chest pain that occurs when acid runs through the tube that carries food. It may appear as chest pain along with an acidic taste in your mouth which is a common differentiator from a heart attack.
  • Esophagitis: When stomach acids start filling up the oesophagus, it may lead to difficult and painful swallowing and intensive chest pain.
  • GallstonesGallstones may create pain in the upper abdomen, back and chest. Gallstones that cause pain should be removed immediately.

Lung-related causes of chest pain

  • Pneumonia: Leads to chest pain that worsens with breathing
  • Viral bronchitis: Leads to soreness around the chest that results in chest and muscle pain
  • Pneumothorax: It is caused by a leak of air between the walls of the lungs and chest, which causes a sudden chest pain
  • Blood clot: This causes a sharp excruciating pain that worsens as you breathe.
  • Bronchospasm: Gives a feeling of chest tightness and pressure in the chest area.

Muscle or bone-related causes of chest pain

  • Costochondritis: In this condition, the cartilage that connects the ribs with the breast bones becomes inflamed and causes chest pain
  • Sore ribs

How to identify if chest pain is heart-related?

If you notice one or more symptoms from the below-mentioned, it is a sure-shot sign of a heart attack or heart disease. Reach emergency immediately in case of these symptoms:

  • Discomfort, pressure, heaviness, tightness, squeezing, or pain in your chest or arm or below your breastbone
  • Discomfort that goes into your back, jaw, throat, or arm
  • Fullness, indigestion, or a choking feeling (it may feel like heartburn) 
  • Sweating, upset stomach, vomiting, or dizziness ·
  • Severe weakness, anxiety, fatigue, or shortness of breath
  • Fast or uneven heartbeat