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Causes
By Mayo Clinic staff
Chest pain has many possible causes, all of which deserve medical attention.
Heart-related causes
Examples of heart-related causes of chest pain include:
- Heart attack. A heart attack is a result of a blood clot that's blocking blood flow to your heart muscle.
- Angina. Thick plaques can gradually build up on the inner walls of the arteries that carry blood to your heart. These plaques narrow the arteries and restrict the heart's blood supply, particularly during exertion.
- Aortic dissection. This life-threatening condition involves the main artery leading from your heart — your aorta. If the inner layers of this blood vessel separate, blood will be forced between the layers and can cause the aorta to rupture.
- Pericarditis. This condition, an inflammation of the sac surrounding your heart, is short-lived and often related to a viral infection.
Digestive causes
Chest pain can be caused by disorders of the digestive system, including:
- Heartburn. This painful, burning sensation behind your breastbone occurs when stomach acid washes up from your stomach into the esophagus — the tube that connects your throat to your stomach.
- Swallowing disorders. Disorders of the esophagus can make swallowing difficult and even painful.
- Gallbladder or pancreas problems. Gallstones or inflammation of your gallbladder or pancreas can cause abdominal pain that radiates to your chest.
Muscle and bone causes
Some types of chest pain are associated with injuries and other problems affecting the structures that make up the chest wall. Examples include:
- Costochondritis. In this condition, the cartilage of your rib cage, particularly the cartilage that joins your ribs to your breastbone, becomes inflamed and painful.
- Sore muscles. Chronic pain syndromes, such as fibromyalgia, can produce persistent muscle-related chest pain.
- Injured ribs. A bruised or broken rib can cause chest pain.
Lung-related causes
Many lung disorders can cause chest pain, including:
- Pulmonary embolism. This cause of chest pain occurs when a blood clot becomes lodged in a lung (pulmonary) artery, blocking blood flow to lung tissue.
- Pleurisy. If the membrane that covers your lungs becomes inflamed, it can cause chest pain that's made worse when you inhale or cough.
- Collapsed lung. The chest pain associated with a collapsed lung typically begins suddenly and can last for hours. A collapsed lung occurs when air leaks into the space between the lung and the ribs.
- Pulmonary hypertension. High blood pressure in the arteries carrying blood to the lungs (pulmonary hypertension) also can produce chest pain.
Other causes
Chest pain can also be caused by:
- Panic attack. If you experience periods of intense fear accompanied by chest pain, rapid heartbeat, rapid breathing, profuse sweating and shortness of breath, you may be experiencing a panic attack.
- Shingles. Caused by a reactivation of the chickenpox virus, shingles can produce pain and a band of blisters from your back around to your chest wall.
References
- Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed Oct. 3, 2011.
- Brown JE, et al. Chest pain. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed Oct. 3, 2011.
- Meisei JL. Diagnostic approach to chest pain in adults. http://www.uptodate.com/home/index.html. Accessed Oct. 4, 2011.
- Sabatine MS, et al. Approach to the patient with chest pain. In: Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0398-6..C2009-0-59734-6--TOP&isbn=978-1-4377-0398-6&about=true&uniqId=236798031-10. Accessed Oct. 4, 2011.
- Meisei JL. Differential diagnostic of chest pain in adults. http://www.uptodate.com/home/index.html. Accessed Oct. 4, 2011.
- Lee-Chiong L, et al. Evaluation and treatment of chest pain. In: Mason RJ, et al. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/das/book/body/192068760-2/0/1288/0.html. Accessed Oct. 5, 2011.
- Yelland M, et al. An algorithm for the diagnosis and management of chest pain in primary care. Medical Clinics of North America. 2010;94:349.
- What is coronary artery bypass grafting? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/cabg. Accessed Oct. 5, 2011.
- Ankel F. Aortic dissection: Management. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed Oct. 5, 2011.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 17, 2011.
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