Learn All about Chest Pain

Chest pain is pain located between the neck and abdomen. Its has various causes and may be cardiac or non-cardiac. In this article, we'll describe its characteristics.
Learn All about Chest Pain

Last update: 27 February, 2020

Chest pain can come from any structure that’s in the chest. It can originate from an organ such as the esophagus or the muscles, nerves, or ribs. In this regard, it may also spread, meaning that the pain can travel to the neck, upper limbs, or even to the face.

Sometimes, this pain begins as back pain. However, this depends on the origin of the pain. However, to be considered chest pain, it must manifest in the front.

Many people fear this type of pain. This is because they unconsciously associate it with heart problems. Approximately 5% of emergency service consultations are attributed to chest pain. It’s less common in pediatrics, constituting less than 1% of emergency visits at that age.

In this article, we’ll take a closer look at what may cause this type of pain.

For pain to be considered chest pain, it should come from some area between the neck and the abdomen. Some may describe the feeling as pain, while others may simply consider it bothersome or tightness.

The two categories of chest pain

Experts usually divide this pain into two main groups: cardiac and non-cardiac. This allows doctors to quickly distinguish between the pain that requires urgent attention from the one that can be treated less urgently.

Below, we’ll list the cardiac causes of this pain. Then, we’ll also mention some groups of structures that may cause non-cardiac chest pain.

Cardiac causes

  • Ischemic heart disease. This pain is the key sign of angina pectoris and heart attack. It’s a very intense and incapacitating pain that manifests with tightness. Also, it’s located in the heart area and radiates to the upper limbs and neck. This pain represents an absolute urgency.
  • Aortic rupture. Although the aorta has a thick wall that withstands high pressures, it still may break. This is an uncommon clinical condition called aortic dissection that causes severe pain. It also requires urgent attention.
  • Pericarditis. The pericardium is the lining of the heart. For various reasons, it can accumulate liquid and swell, producing pericarditis. Pericarditis manifests with chest pain that can be intermittent and often change depending on the person’s posture.

Non-cardiac causes: Pulmonary chest pain

  • Pneumonia. Microbial lung infections can cause this pain. It may be continuous and intensify with a cough or unusual breathing movements. In general, it’s a pain in the side that coincides with the infected area.
  • Pulmonary embolism. The arteries and veins of the respiratory system can become clogged with clots in a condition called pulmonary embolism. These clots can form in the lungs or come, through circulation, from other body parts. This is also an extremely urgent condition.
  • Pneumothorax. Just as the heart is surrounded by the pericardium, the lungs are surrounded by the pleura. If the space that the pleura forms fill with air, it’s called pneumothorax. It’s very painful and may also be accompanied by symptoms such as breathlessness.
  • Pleurisy. The pleura is likely to swell. This is known as pleurisy or pleuritis. As with pericarditis, the pain is intermittent and may vary with changes in posture.
A woman with esophageal pain in the chest.
Esophageal chest pain usually occurs in the middle of the chest.

Non-cardiac pain: Pain that arises in the digestive tract

  • Esophageal spasms. The esophagus runs through the center of the chest to communicate the mouth to the stomach. As it’s a hollow body whose wall is made of muscle, it may suffer spasms. When this happens, the esophagus closes in on itself, causing chest pain and preventing the passage of food.
  • Gastritis. Although the stomach is lower, gastritis and dyspepsia sometimes manifest upwards in the chest. Gastritis is also often accompanied by digestive symptoms, such as burping, reflux, and nausea. The pain in the chest caused by gastroesophageal reflux feels like a painful tie in the center of the chest.
  • Gallstones. If the gallbladder has gallstones, it can also affect the chest. However, abdominal pain is more common. According to the anatomical position of the gallbladder and the position of the gallstones, some people perceive pain in the right pulmonary region and up to the right shoulder.
An electrocardiogram.
An electrocardiogram is one of the tests doctors request when a patient experiences pain in their chest.

Keep discovering in this article: Chest Pains – Why Do They Happen

Other causes of pain in your chest

As we mentioned above, besides the organs of the chest and abdomen, other structures and situations can cause this pain. Thus, it’s always necessary for doctors to discard the most serious causes of this pain before trying to diagnose other causes that can be treated with less urgency.

These causes are:

  • Psychogenic causes. A panic attack, for example, can cause chest pain. However, the pain is psychological, not anatomical. There’s a feeling of tightness and discomfort in the chest that isn’t caused by an organ or malfunction.
  • Costochondritis. This is inflammation of the cartilage that connects the ribs to the sternum. An intense effort or blow can cause it. It’s easy to treat with anti-inflammatory drugs and local cooling.
  • Myalgia. In this case, the muscles that form the chest wall may hurt, either due to effort, strains, hematomas from a blow, or inflammation. Generally, its treatment consists of anti-inflammatory drugs.
  • Neuritis. The nerves that pass between the ribs may swell and be a source of chest pain. A classic example is herpes zoster, in which the viral infection manifests with severe pain and burning that runs along the affected nerve.

As you can see, there are countless causes of this type of pain. Make sure to see your doctor if you have any questions. 

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