5 Common Causes Of Chest Pain You Should Be Aware Of

Having chest pain? Read this article to discover four other common causes of chest pain apart from heart attack.

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Chest pain is the reason for over 7 million annual emergency department (ED) visits in the United States. It's the second most common reason for visits to the ED.

You may feel chest pain because of an illness, injury, or stress. The pain sensation could vary from being sharp to stabbing or burning. It can be mild or severe and may be persistent or come and go.

Some causes of chest pain are life-threatening and will cause health complications if not correctly diagnosed, managed, and treated. Read on to discover five health conditions that can cause chest pain, their symptoms, and treatment.

Heart Attack (Myocardial Infarction or MI)

A heart attack, also called a myocardial infarction (MI), happens when a part of your heart muscle is damaged because of a blockage of blood flow to it.

A blood clot in a coronary artery – any artery that supplies blood to the heart – due to a buildup of fat or cholesterol causes the blockage. This condition is called coronary artery disease (CAD) or coronary heart disease (CHD).

Angina, the chest pain associated with a heart attack, is one of the first symptoms of a heart attack. The sensation has been described as a pressure, squeezing, tightening, or sharp pain in the center or left side of the chest.

Angina is the chest pain you feel when your heart lacks oxygen. You should watch out for a heart attack if you have angina.

Chest pain caused by a heart attack could last longer than a few minutes or fade and return. It may spread to your arms, shoulders, back, neck, or jaw.

A heart attack is a common emergency medical condition. Every 40 seconds, someone experiences a heart attack in the United States, which amounts to about 805,000 people yearly.

Contact emergency health services if you experience symptoms of a heart attack. In the US, you can call 911.

Around 47% of US adults have at least one of the major risk factors for heart disease:

• high blood pressure
• high blood cholesterol
• smoking

Several health conditions and your lifestyle, age, and family medical history are also risk factors for CAD and heart attack.

Symptoms Of Heart Attack

Apart from chest pain, other heart attack symptoms are:

• Shortness of breath
• Weakness
• Dizziness
• Sweating
• Anxiety
• Tiredness and nausea (common in women)
• Coughing

Pericarditis

Pericarditis causes a sharp chest pain that increases with deep breaths, coughing, swallowing, and lying down. It's another common cause of chest pain in the US.

You may also feel neck, shoulder, stomach, or back pain. You often feel better when you sit up or lean forward.

Pericarditis is the swelling of the pericardium, a thin fibrous fluid-filled elastic sac with double layers surrounding your heart.

Although the exact cause is usually unknown, a viral infection in the chest is the most common cause. Bacteria and fungal infections are less common causes. It can also occur after a heart attack.

Research reveals that pericarditis makes up 5% of visits to the ED for chest pain and 0.1% of admitted patients. Estimates based on the 2020 US census suggest that pericarditis is a rare condition affecting about 160,000 Americans. Although it can affect anybody, 16-65 years old males are more at risk.

Chest pain caused by pericarditis can begin suddenly, and episodes may stop in one to three weeks (acute pericarditis).

Symptoms may reoccur (recurrent pericarditis) and continue for weeks. It becomes a chronic condition when symptoms persist for more than three months.

Common risk factors of pericarditis are:

• Chest or heart injury from a heart attack, heart surgery, or accident.
• Heart inflammation
• Radiation to the chest
• Medical conditions, such as HIV/AIDS, tuberculosis (TB), immune system disorders, cancer, rheumatic fever, and kidney failure.
• Certain medications, including some medicine for cancer and autoimmune diseases, procainamide, hydralazine, and isoniazid.

Pericarditis is treatable and usually not life-threatening. However, you should seek medical care if symptoms persist because untreated chronic pericarditis can cause serious heart problems.

Symptoms Of Pericarditis

Aside from chest pain, other signs of pericarditis are:

• Having difficulty breathing when lying down
• Heart palpitations, i.e., irregular heartbeat
• Swollen abdomen, legs, ankles, and feet
• Dry cough
• Fever
• Fatigue and faintness
• Anxiety

Gastroesophageal Reflux Disease (GERD) Or Chronic Acid Reflux

Gastroesophageal reflux disease (GERD), also called chronic acid reflux, is a long-term digestive disorder in which your stomach's acid contents flow back into your food pipe (esophagus).

The regurgitated stomach acid irritates your food pipe and causes heartburn, a burning pain in the middle of your chest that may spread to your neck. The pain may start after eating or when you lie down. You may also experience non-burning chest and back aches.

GERD affects 20% of the US population and is among the most common digestive diseases. It's more common in men than women.

The exact cause of GERD is unknown, but the following factors can increase your risk:

• Impaired lower esophageal sphincter (LES)
• Being 50 years or older
• Smoking
• Obesity
• Excess alcohol intake
• Medical conditions such as hiatal hernia and scleroderma
• Pregnancy
• Lying down shortly after eating
• Some medicines, including nitroglycerin, NSAIDs, anticholinergics, benzodiazepines, calcium channel blockers, albuterol, and antidepressants

Non-erosive reflux disease (NERD) and erosive reflux disease (ERD) or erosive esophagitis (EE) are the two types of GERD. In ERD, the stomach acid injures your food pipe, while there's no injury in NERD.

Seek professional medical care if you experience symptoms of GERD to prevent damage to your esophagus, such as sores and Barrett's esophagus.

Symptoms Of GERD

The main symptoms of GERD are heartburn and regurgitation of bitter liquid into the throat and mouth.

Other signs include:

• Difficulty or pain when swallowing food or liquids
• Upper abdominal pain
• Nausea
• Belching
• Non-burning chest pain
• Back pain
• Chronic cough
• Dental erosions, i.e., acid wears away the surface of your teeth
• Sore throat and a scratchy voice (hoarseness)
• Feeling like there's a lump in your throat (Globus sensation)

Peptic Ulcer Disease (PUD)

Peptic ulcers cause heartburn that worsens when you lie down. Estimates suggest that around 1% to 6% of Americans have peptic ulcers.

Peptic ulcer disease (PUD) is a gastrointestinal condition where stomach acid chops away at the lining of your stomach or the upper part of your small intestine (duodenum), causing painful sores.

It's called gastric or stomach ulcer when the sore is on the stomach and duodenal ulcer when it's on the duodenum.

More peptic ulcers are caused by Helicobacter pylori (H. pylori) infection, a contagious bacterial infection, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, than any other culprit.

Other infections, drugs, gastrointestinal surgeries, age, and certain diseases or health conditions are rare causes and risk factors of PUD.

Stomach and intestinal bleeding and ulcers spreading to other organs are some complications of peptic ulcers.

Symptoms Of Peptic Ulcer

The most common symptom of peptic ulcer is a dull or burning pain in the upper part of your belly (between your belly button and breastbone).

In stomach ulcers, the pain intensifies when you eat. But the pain goes away when you eat if it's a duodenal ulcer.

In addition to stomach pain and heartburn, you may also see the following signs:

• An uncomfortable feeling of fullness during or after meals
• Bloating
• Belching
• Nausea and vomiting

Many people with PUD only start having symptoms when they've developed complications. Some of the signs are:

• Persistent stomach pain
• Nausea and vomiting
• Pooping dark or blood-mixed stools
• Vomiting blood
• Fainting
• Unexplained weight loss or weight gain
• A racing pulse

Ensure you seek medical help immediately if you notice these symptoms.

Pneumonia

Pneumonia causes a stabbing chest pain that worsens when you cough, laugh, or breathe deeply.

Pneumonia is a lung infection that causes the air sacs (alveoli) in one or both of your lungs to swell and fill up with fluid or pus. It's caused by viruses, bacteria, and fungi.

You can catch pneumonia from another person through coughs, sneezes, and touching infected objects.

Some common factors that increase your risk of having pneumonia are:

• Illnesses such as covid-19, flu, common cold, and other infections
• Long stay at the hospital or care home
• Being a senior citizen
• Smoking
• Weak immune system
• Diabetes, lung and heart diseases, and other medical conditions.

The CDC reports that 1.5 million ED patients in the US had pneumonia in 2020, and over 40,000 people died from it in 2021. It's most common in adults.

See a doctor if you experience symptoms of pneumonia and get early treatment to prevent complications. Getting vaccinated for some infections can reduce your risk of pneumonia.

Symptoms Of Pneumonia

In addition to chest pain, you may experience the following symptoms:

• Coughing out yellow, green, or bloody phlegm.
• Dry cough
• High temperature and chills
• Heart palpitations
• Short breaths and breathing with wheezing noises
• Fatigue
• Nausea and vomiting
• Muscle ache
• Headache
• Lower-than-normal temperature and confusion in older adults

Diagnosis And Treatment Of Chest Pain

Your combined symptoms determine the method of diagnosis. Ways to diagnose the cause of your chest pain may include:

• Assessing and analyzing your symptoms
• Your Medical history
• Your Family medical history
• A chest X-ray
• Blood tests to check for infections
• An electrocardiogram (ECG/EKG)
• An echocardiogram (echo)
• Digestive tract diagnostic tests, scans, and procedures
• A computerized tomography (CT) scan
• A cardiac catheterization/ coronary catheterization

The course of treatment depends on the cause of your chest pain and its severity. One or a combination of the following may be ideal:

• Lifestyle changes such as improving your diet, exercising, quitting smoking, and reducing alcohol use
• Medication
• Surgery

Getting diagnosed and treated early can help you feel better and lower the risk of long-term complications from the illness causing your chest pain.

Speak to a doctor if you have chest pain or experience the symptoms of any of the conditions discussed in this article.

Bottom Line

Chest pain can be mild or severe. No matter the cause of the pain, it can interfere with your daily life. Heart attack, pericarditis, GERD, peptic ulcers, and pneumonia are common causes of chest pain.

Treat an episode or repeated episodes of chest pain as a thing of concern. Seek medical help immediately because an early diagnosis and treatment of the cause will help you manage the condition, increase your chance of feeling better as soon as possible and reduce your risk of having complications.

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