Chest pain sends about 7 million Americans to the emergency room each year, according to an Ohio State University study.
There’s no doubt about it: Chest pain can be frightening. The good news is it’s not always a sign of something serious.
A heart attack is a worst-case scenario, but chest pain or tightness can be something simple like acid reflux or nerve pain.
While chest pain should always be taken seriously, it doesn’t even necessarily involve the heart at all. Up to 25% of cases of chest pain are caused by a non-cardiac issue.
Here are some of the most common causes of chest pain and whether or not you need to take action.
#1. COPD Is a Common Cause of Chest Pain
Chronic obstructive pulmonary disease (COPD) is a form of lung disease that worsens over time. COPD can come with a persistent cough, shortness of breath, chest tightness, and chest pain.
If you struggle to breathe and get winded easily, especially while active, your chest pain may be the result of lung disease — not a cardiac issue.
Dietary changes, quitting smoking, and medication can all ease the chest tightness and pain of COPD.
#2. Chest Tightness Is a Common Asthma Symptom
If you have asthma, you may experience a range of symptoms like wheezing, coughing, and chest tightness, which may feel like a heavyweight on your chest, tightness, or actual pain. During an asthma attack, it can be difficult to breathe as the airways close.
You may have asthma without even realizing it. Asthma can develop at any time, and it doesn’t always come with the hallmark symptoms.
One ER survey found that 76% of people with asthma experience chest pain. A recent study published in the Annals of Allergy, Asthma & Immunology found that chest pain or tightness can be the only symptom of asthma for some people.
#3. Sharp Chest Pain Is a Primary Sign of Pleurisy
Pleurisy refers to inflammation of the membranes covering the lungs. This condition, often caused by a viral infection, can cause very sharp or stabbing chest pain that gets worse when you move, cough, sneeze, or breathe deeply.
Most cases of pleurisy are caused by a viral infection but it can also be caused by pneumonia and autoimmune disorders.
Pleurisy can be diagnosed by removing some fluid from the pleura of your lungs. Once diagnosed, pleurisy should be treated with NSAIDs, prescription pain medication, and sometimes antibiotics.
#4. GERD Is the Most Common Digestive Cause of Chest Pain
Gastroesophageal reflux disease, or GERD, is a chronic condition of the digestive system that happens when stomach acid flows back into the esophagus. This can irritate and damage the lining of the esophagus.
Chest pain from GERD can mimic the pain of angina pectoris. You may feel a burning or squeezing sensation in your just behind the sternum that may radiate to the arms, jaw, back, or neck.
You may feel severe pain in your chest when you cough or breath deeply, but the pain will probably feel close to the surface of the skin rather than deep in the chest. Taking antacids usually relieves the pain.
#5. Several Musculoskeletal Issues Cause Chest Pain
A large share of chest pain is the result of an underlying musculoskeletal problem. Up to 25% of patients seen in an ER and over one-third of people in non-emergency clinics who report chest pain have noncardiac or atypical pain, according to a major study on chest wall pain and musculoskeletal syndromes.
This type of chest pain is sometimes caused by rheumatic conditions like rheumatoid arthritis (RA) and fibromyalgia.
People with fibromyalgia, in particular, can develop a condition called costochondritis, which causes pain and tenderness around the rib cage and breastbone. Up to 70% of people with fibromyalgia experience costochondritis chest pain, according to Very Well Health.
#6. Panic Disorder and Panic Attacks Can Cause Chest Tightness
Panic disorder is a common type of anxiety disorder that leads to recurring and usually unexpected panic attacks. This disorder can develop at any time.
If you have never been diagnosed with panic disorder, the onset of a panic attack can feel very much like a heart attack with shortness of breath, fast heartbeat, numbness, and chest pain. It’s believed that up to 25% of people who see a doctor for chest pain have panic disorder.
#7. Pulmonary Hypertension Can Cause Chest Tightness and Fainting
Pulmonary hypertension is a condition in which the pressure in the arteries that serve the lungs is too high, putting pressure on the walls of the arteries.
When pulmonary hypertension first develops, you will probably notice shortness of breath when you are active.
Eventually, the disease will worsen and make you feel tired all the time. It can also cause swelling of the legs, fainting, a rapid heartbeat, and pressure or tightness in the chest.
#8. Myocarditis May Cause Mild Chest Pain and Swelling
Myocarditis is an inflammation of the muscles of the heart, usually due to a viral infection. This condition can cause chest pain, but it’s usually mild or pressure in the chest. Myocarditis can also cause swelling in your legs, heart palpitations, and shortness of breath.
Myocarditis does not involve any blockages in the blood vessels, but the symptoms can resemble a heart attack.
#9. Hyperthyroidism Can Affect Your Heart and Cause Chest Tightness
Hyperthyroidism is a condition in which the thyroid gland is overactive and makes too much thyroid hormone.
This speeds up most systems in the body and may cause difficulty sleeping, feeling too hot, fast heart rate, heart palpitations, nervousness, and weight loss.
When it isn’t treated, hyperthyroidism can cause several problems like high blood pressure and even heart failure because the high hormone level forces the heart to beat faster and harder.
It can also cause chest pain because faster and more forceful pumping requires more oxygen. When someone with hyperthyroidism also has a clogged coronary artery, angina is likely to follow, according to Harvard Medical Center.
#10. Cardiomyopathy Can Cause Pain After Exercise or Eating
If you notice moderate chest pain that gets worse after a heavy meal or exercise, it may be caused by cardiomyopathy.
This is a broad term that refers to several diseases of the heart muscle that can make the muscle thicker, thinner, or interfere with the heart’s ability to pump blood.
Cardiomyopathy can cause swelling in the legs, heart palpitations, irregular heart rhythm, shortness of breath that gets worse when you’re active, and sometimes chest pain.
#11. Angina Can Be Mistaken for a Heart Attack
Angina is a specific type of chest pain that happens when blood is flowing to the heart but the rate is reduced. About 9 million Americans have chronic angina, which causes pain in the chest that feels like pressure or that your heart is actually being squeezed, according to a study published by the American College of Cardiology.
Angina can be mistaken for a heart attack, but it doesn’t cause permanent damage to the heart. There are two types of angina: unstable angina which can happen at any time and stable angina, which happens when your heart pumps harder such as during exercise.
One of the most common causes of angina is coronary artery disease (CAD). This cardiac disease is caused by a blockage in blood vessels that reduce the rate of blood flow and how much oxygen reaches the heart muscles.
#12. A Heart Attack Is the Most Serious Cause of Chest Pain
Sometimes the cause of your chest pain is what you fear: a heart attack. When the pain is caused by a heart attack, it may feel like tightness, pressure, or sharp, stabbing pain. Heart attacks are caused by a blockage in an artery supplying oxygenated blood to the heart.
A heart attack can also come with other symptoms:
- Fast pulse
- Sense of choking
- Severe weakness
- Cold sweat
- Shortness of breath
- Numbness in one hand or arm
It’s very important to understand that the signs of a heart attack can be different for women than men. This video goes over common heart attack symptoms, including those women tend to experience that may not be obvious signs of cardiac problems.
If you have symptoms of a heart attack, consider it a medical emergency, and seek medical attention right away.
What Else Can Cause Chest Pain?
There are many other issues that can lead to chest pain, although you should know that in many cases, the cause of the pain is unknown.
- #13. A pulled muscle in the chest wall
- #14. Pneumonia
- #15. Aortic dissection or a tear in the inner lining of the aorta
- #16. Stress cardiomyopathy or broken heart syndrome
- #17. Pulmonary embolism or a blockage in the pulmonary artery in the lung
- #18. Pneumothorax or a build-up of air in the pleural sac between the lungs and the chest wall
- #19. Substance-related chest pain caused by cocaine or another drug
- #20. Shingles which affects 1 out of 3 people at some point
- #21. Gallstones
- #22. Pancreatitis or inflammation of the pancreas
- #23. Injury to a rib
- #24. Ulcer
- #25. Lung cancer