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Chest pain: what are the common causes?
Chest pain can be caused by angina, myocarditis and even a heart attack, but BHF Senior Cardiac Nurse Regina Giblin explains it's not always related to your heart. Other common causes include anxiety, heartburn, chest infection and muscle pain.
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When to call 999?
Call 999 immediately if you or someone else shows signs of a heart attack, stroke or cardiac arrest.
Every second counts. These are life-threatening emergencies that require urgent medical attention.
Key symptoms include:
- Chest pain that feels like a band or weight squeezing your chest.
- Breathing problems - choking or gasping.
- Face drooping, difficulty speaking, arm weakness.
- Loss of consciousness.
There are many possible causes of chest pain. Some are related to the heart like heart attack, angina, myocarditis or pericarditis, and some are not, such as anxiety, heartburn, chest infection and muscle pain.
This article will explore both, but first let's look at the different types of pain you might experience that can come from the chest.
What does chest pain feel like?
People experience pain differently and pain can be difficult to describe, especially when it's the kind of pain that we tend to associate with life-threatening conditions.
Knowing how to describe what you're experiencing may help you understand, explain and manage your symptoms.
For example, chest pain may feel like:
- tightness
- squeezing
- a dull ache
- pressure, like someone is sitting on your chest.
You can also just feel uncomfortable, like something is off but it's not stopping you from getting on with life.
Chest pain can be felt in different places in your chest:
- on the left side
- on the right side
- at the centre behind the breastbone (sternum).
It can feel like it’s only in one place (localised) or it can be spreading (radiating) to other parts of your body, like the shoulder and arm, or neck and jaw, or stomach and back.
Chest pain can also be constant or it may come in waves.
It may last different amounts of time and vary in how intense it feels.
Chest pain can come with different triggers, which may suggest its cause.
For example, if you get chest pain after you’ve had lunch, it may be a sign of indigestion.
If you only get chest pain in a specific position, it may be muscular pain.
If chest pain happens when you take a deep breath, it may be lung related.
The cause of the chest pain will also affect how long it lasts.
It can be hard to tell the cause of chest pain, and if you are unsure, make sure you seek medical help.
What are the common causes of heart-related chest pain?
Common causes of heart-related chest pain include heart attack, angina, myocarditis and pericarditis.
Heart attack
Symptoms of a heart attack can include:
- sudden chest pain or discomfort that does not go away
- pressure, squeezing or heaviness in your chest that may spread to your left or right arm or to your neck, jaw, back or stomach
- feeling sick, sweaty, light-headed or short of breath.
Coughing or wheezing can also happen because of fluid build-up in the lungs.
If you suspect that you are having a heart attack, call 999.
Angina
Angina may feel like:
- pressure, tightness or squeezing in your chest
- discomfort in the shoulders, arms, neck, jaw, back or stomach.
It can make you fatigued and dizzy. You may sweat and feel sick and breathless.
These symptoms can be brought on by exercise, stress, emotion, or cold temperatures.
If you’ve not been diagnosed with angina and you have chest pain that stops after a few minutes of resting, get an urgent doctor’s appointment.
If the pain does not stop after a few minutes’ rest, call 999 immediately because you could be having a heart attack.
If you have been diagnosed with angina but it feels worse, happens more often, or changes in any way, talk to your doctor as soon as you can.
If your chest pain doesn’t stop after a few minutes’ rest, and two doses of your GTN medication, call 999 immediately because this could be a heart attack.
Myocarditis and pericarditis
Myocarditis and pericarditis are when certain parts of the heart become inflamed, usually following a virus.
In both myocarditis and pericarditis, chest pain can feel like:
- a sharp pain or tightness
- or a dull, pressure-like pain.
Pericarditis sometimes is felt more on the left-hand side of the chest and tends to get worse when coughing, swallowing or lying down.
Both myocarditis and pericarditis may also cause a high temperature, shivers, trouble breathing, light-headedness, and feeling sick.
The table below goes through different types of chest pain symptoms, the possible reasons for them and what to do if you experience them.
Chest Pain Symptoms |
Possible Reasons |
What to do |
|---|---|---|
|
Sudden chest pain or discomfort that does not go away Pressure, squeezing or heaviness in your chest that may spread to left or right arm or to neck, jaw, back or stomach Feeling sick, sweaty, light-headed or short of breath |
Heart attack |
Call 999 Sit down and wait for ambulance |
|
Pressure, tightness or squeezing in your chest Discomfort in the shoulders, arms, neck, jaw, back or stomach Fatigue, dizziness, breathlessness and feeling sick |
Angina |
If your chest pain stops after a few minutes' rest, get an urgent doctor's appointment If it does not stop, call 999 immediately as it may be a heart attack |
|
A sharp chest pain or tightness Or a dull, pressure-like pain Sometimes with a high temperature, shivers, trouble breathing, light-headedness, and feeling sick |
Myocarditis/Pericarditis |
Call your GP to make an urgent appointment, contact NHS 111, or attend A&E to be assessed |
What are the common causes of non-heart related chest pain?
If you have chest pain it's natural to connect it to your heart.
Common causes of chest pain that are not related to the heart include anxiety, heartburn, chest infection, muscle pain, injuries and inflammation.
Anxiety
Anxiety-related chest pain, which may feel similar to heart-related chest pain, is common and can be difficult to manage.
Your chest may feel squeezed, and your heart may feel like it’s racing and about to jump out of your chest.
When you touch your wrist to check your pulse, it may feel like your heart is skipping beats.
The intensity of this feeling can make you dizzy, disorientated, and breathless.
Anxiety-related chest pain affects many people.
Medicines, breathing techniques, and psychotherapy, can help you cope with, or even control, the symptoms of anxiety over time.
- Read more about mindfulness and meditation and try our 3-minute meditation.
Heartburn
Heartburn, which may be linked to indigestion, is a common cause of chest pain.
Symptoms, such as a burning sensation in the middle of your chest, are often worse after eating, when lying down and when bending over.
Chest infection
Chest pain or discomfort can also be caused by a chest infection.
You may also have a chesty cough which may come with green or yellow mucus, a high temperature and tiredness.
Pneumonia can cause similar symptoms.
Muscular chest pain, injuries and inflammation
Chest pain, tenderness or discomfort can be caused by injuries. You may also feel these sensations in the shoulder, neck, or upper back.
If you feel them after exercise, carrying heavy shopping, or sleeping in an awkward position, they are probably linked to strain on your muscles and tendons.
Look out for any swelling and bruising, which may be a sign of an injury.
If your chest is painful to touch, this could be a condition called costochondritis, caused by inflammation in the rib cage.
Speak to your GP if you’re experiencing any new or ongoing chest discomfort.
Are there other serious causes of chest pain?
Less common but serious causes of chest pain include:
- aortic dissection
- pulmonary embolism
- spontaneous coronary artery dissection (also known as SCAD)
If you experience any of the symptoms associated with these conditions, you should phone 999 immediately to get medical help.
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