Chest pain can manifest itself in different ways, such as throbbing, tightness, or burning.
It can also be focused or travel to the neck, jaw, back or arms. Being a very common condition, it is difficult to determine its origin with certainty. Here we review what are usually the main causes of chest pain.
Angina is a condition that occurs when there is insufficient blood flow through the blood vessels of the heart muscle.
As a result, you may feel pressure, squeezing, burning, or tightness in the chest area. These discomforts can also be experienced in the arms, shoulders, neck, jaw, throat or back.
Asthma is a chronic disease characterized by coughing, chest tightness, and shortness of breath. This usually occurs several times a day or a week and in some cases is aggravated at night or after physical activity.
The main triggers for the appearance of this disease are:
- Dust mites.
- Cockroach allergens.
- Atmospheric pollution.
- Smoke of the tabacco.
- Smoke from burning wood or grass.
- Infections associated with influenza or colds.
Heart attack or myocardial infarction occurs when blood flow to the heart is blocked. Usually, that blockage occurs from a buildup of fat, cholesterol, and other plaque-forming substances in the coronary arteries (which feed the heart).
This plaque can often rupture and form clots, which blocks blood flow. This interruption can cause damage or destroy part of the heart muscle.
In addition to chest pain, a heart attack can cause:
- Difficulty breathing.
- Pain in the jaw, neck, back, arms, or shoulders.
- Dizziness or weakness.
A panic attack is an episode of sudden and intense fear, often causing severe physical reactions when there is no real danger or apparent cause.
This type of attack is not lethal, although it can affect people’s quality of life, to the point that they lose control over their actions and thoughts, believing that they are going to die.
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Many people have only one or two panic attacks in their lifetime, and the problem may go away when the stressful situation that triggers it is resolved. However, when these episodes are constant, you can have a condition called “panic disorder.”
In addition to chest pain, a panic attack can cause nausea, dizziness, sweating, a rapid heartbeat, and fear.
Rib injuries, such as fractures, bruises, or breaks, can cause chest pain. The most common causes of this type of injury include car accidents, sports injuries, falls, and even severe or prolonged coughing.
Generally, rib injuries can cause these symptoms:
- Skin discoloration (may turn blue, purple, or yellow).
- Difficulty performing daily activities, such as walking, breathing, coughing, or laughing.
- Pain, on movement or rest.
A pulmonary thromboembolism, also known as a pulmonary embolism, is a condition that occurs when one or more arteries in the lungs become blocked by blood clots.
This can cause different symptoms, such as chest pain, trouble breathing, or a severe cough.
Gastroesophageal reflux disease
Reflux occurs when stomach acid flows into the esophagus, a “tube” that connects the mouth to the stomach. This causes irritation of the lining of the esophagus and symptoms such as:
- Burning sensation or pain in the chest, usually after eating or at bedtime.
- Difficulty to swallow.
- Regurgitation of food or liquids, especially those that are sour.
- Trouble sleeping.
- Chronic cough.
During a hiatal hernia, the upper part of the stomach pushes through the hiatus, a small opening in the diaphragm through which the esophagus passes to join the stomach.
This condition can be mild, usually causing no problems and may even go unnoticed, or severe, causing food and acid to back up into the esophagus. In some cases, it can also be responsible for pain in the chest or abdomen, heartburn, or trouble swallowing or breathing.
Myocarditis or inflammation of the heart muscle is a condition in which the middle layer of the heart wall becomes inflamed. In severe cases, it can weaken the heart, leading to heart failure, abnormal heart rate, and even sudden death.
Symptoms of myocarditis include chest pains and trouble breathing normally.
Pneumonia or pneumonia is an infection that causes inflammation of the air sacs of one or both lungs. This can cause a buildup of fluid or pus in them.
This condition is characterized by coughing up phlegm or pus, fever, chills, trouble breathing, and chest pain.
In many cases chest pain can be due to esophageal problems, the most common being:
- Esophageal hypersensitivity.
- Esophageal rupture.
- Esophageal contraction disorders.
- Drink lots of alcohol.
- Eat spicy food.
- To smoke.
- Suffer too much stress.
- Costochondritis: is the inflammation of the cartilage of the rib cage.
- Aortic dissection: is a separation of the inner layers of the aorta, the main artery that leaves the heart.
- Coronary artery dissection: occurs when the coronary artery tears.
- Pulmonary hypertension: is high blood pressure in the arteries that carry blood to the lungs.
- Hypertrophic cardiomyopathy: occurs when the heart becomes too thick due to genetic factors.
- pancreatitis: is the inflammation of the pancreas.
- pericarditis: is the inflammation of the sac that surrounds the heart.
- Pleurisy: is the inflammation of the membrane that covers the lungs.
- mitral valve prolapse: occurs when a heart valve cannot close completely.
- collapsed lung: occurs when air accumulates in the space between the lungs and the ribs.
- It appears suddenly.
- It gets worse.
- It spreads to other areas of the body, such as the neck, arms, or back.
- It is accompanied by other problems, such as difficulty breathing or swallowing.
A peptic ulcer is a sore in the lining of the stomach or duodenum, which is the first part of the small intestine. Although they do not usually cause intense pain, they can cause discomfort in the chest area.
They are usually the product of bacterial infections, such as Helicobacter Pylori, or long-term use of anti-inflammatory drugs, such as ibuprofen. Other factors that can aggravate your symptoms are:
Other possible causes
Other conditions that may be responsible for chest pain are:
When to see a doctor
Many times a slight bump or injury can cause chest pain, and over time and without treatment it is likely to go away. However, you should see a health professional as soon as possible if your chest pain:
Sources consulted: US National Library of Medicine, Centers for Disease Control and Prevention (CDC), Mayo Clinic, National Heart, Lung, and Blood Institute.