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Common causes of chest pain

All too often, the mention of chest pain conjures up images of a heart attack, but there are plenty of other diseases and conditions that can trigger this symptom. Some of them—like that chest muscle you pulled raking leaves last fall—are more annoying than serious. But others can be far more serious.

Health.com spoke to three leading cardiologists across the country, and all of them reiterated one thing: If you’re having chest pain, and you’re not 100% sure what’s causing it, either call your doctor or call 911.

“I know of one person who died and the last thing in their search bar was ‘heart attack symptoms,’” says Sharonne Hayes, a cardiologist at the Mayo Clinic in Rochester, Minn.

Christine Jellis, MD, PhD, a cardiologist at Cleveland Clinic, seconds that. “As a physician, I would much rather let someone know that it’s nothing to worry about than have someone [come to us] too late and has permanent damage,” Dr. Jellis says.

Here are seven conditions that can cause chest pain—and what everyone should know about to treat them.

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You might be wondering how someone could mistake the symptoms of acid reflux for a heart attack, but there’s a reason why it’s called heartburn, after all.

Gastroesophageal reflux occurs when a person’s stomach contents—including the gastric acids that help break down food—back up into the esophagus, the tube that connects the throat and stomach. Stomach acid is highly acidic, hence, the burning sensation behind your breastbone; on the pH scale, it scores about a 2, falling somewhere between battery acid and vinegar. (Our stomachs are lined with protective membranes that shield it from the corrosive effects of acid, while our esophagus does not.)

The occasional reflux is fairly common and probably nothing to worry about, but if you’re experiencing it twice a week or more, you may have gastroesophageal reflux disease (GERD). Left untreated over time, GERD can cause asthma, chest congestion, and a condition called Barrett’s esophagus, which may increase your chances of developing a rare type of cancer.

Muscle strain

Weekend warriors, take note: If you haven’t lifted anything heavier than a MacBook for more than a few years, you might want to rethink that CrossFit class you signed up for.

It’s possible for someone to mistake a strained chest muscle for something more serious, like a heart attack, says Dr. Jellis. “I had a patient who came in with chest pain and he was worried he was having a heart attack,” she says. “After taking his history, I learned he had moved [to a new house] and hadn’t lifted heavy furniture in years. But he did the right thing, coming in.”

Doctors don’t expect patients to be able to tell the difference between a heart attack and a pulled chest muscle, she says, but a good rule of thumb is that if you can press on the wall of the chest and it feels even more painful, it’s more likely to be a musculoskeletal injury than a problem with your ticker.


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An estimated 13% to 36% of adults who show up to the emergency room or their doctor’s office with acute chest pain are diagnosed with costochondritis, or inflammation where a rib bone meets up with the cartilage, according to a 2009 review in the journal American Family Physician. Although doctors can’t always pinpoint what triggered the condition, the culprits can range from viral infections to chest injuries. Typically, people feel a type of pressure on their chest wall and—similar to a strained muscle—a tenderness when they press on the area.

In this case, a doctor will probably start by taking your medical history and doing a physical exam. “A physician is going to want to rule out cardiac and other serious issues first,” says Dr. Jellis. “It’ll most likely be a diagnosis by exclusion.” If you do have costochondritis, the pain typically goes away in a few days or weeks; taking over-the-counter painkillers can help.


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The virus that causes chickenpox lingers in your body long after the spots have faded. In fact, varicella-zoster can reactivate in adulthood (usually in people older than 50) as a disease called shingles. The first symptoms include itching and burning skin. If the area over the chest is affected, someone might mistake this new pain for a heart attack or other cardiac issue, says Salman Arain, MD, an interventional cardiologist with McGovern Medical School at the University of Texas Health Science Center at Houston and the Memorial Hermann Heart & Vascular Institute-Texas Medical Center. A few days later, however, the telltale rash can appear, followed by blisters.

If you think you have shingles, you should call your doctor ASAP. Antiviral medications can lessen the pain and shorten the duration of the symptoms, but only if you take them within 72 hours of the rash appearing. If it’s too late to take antivirals, your doctor can prescribe a prescription painkiller.

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