Chest pain

Definition

Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.

Alternative Names

Considerations

Many people with chest pain fear a heart attack. However, there are many possible causes of chest pain. Some causes are mildly inconvenient, while other causes are serious, even life-threatening. Any organ or tissue in your chest can be the source of pain, including your heart, lungs, esophagus, muscles, ribs, tendons, or nerves.

Angina is a type of heart-related chest pain. This pain occurs because your heart is not getting enough blood and oxygen. Angina pain can be similar to the pain of a heart attack.

Angina is called stable angina when your chest pain begins at a predictable level of activity. (For example, when you walk up a steep hill.) However, if your chest pain happens unexpectedly after light activity or occurs at rest, this is called unstable angina. This is a more dangerous form of angina and you need to be seen in an emergency room right away.

Causes

Other causes of chest pain include:

• Asthma, which is generally accompanied by shortness of breath, wheezing, or cough.
• Pneumonia, a blood clot to the lung (pulmonary embolism), the collapse of a small area of a lung (pneumothorax), or inflammation of the lining around the lung (pleurisy). In these cases, the chest pain often worsens when you take a deep breath or cough and usually feels sharp.
• Strain or inflammation of the muscles and tendons between the ribs.
• Anxiety and rapid breathing.

Chest pain can also be related to problems with your digestive system. These include stomach ulcer, gallbladder disease, gallstones, indigestion, heartburn, or gastroesophageal reflux (when acid from your stomach backs up into your esophagus).

Ulcer pain burns if your stomach is empty and feels better with food. Gallbladder pain often gets worse after a meal, especially a fatty meal.

In children, most chest pain is not caused by the heart.

References

Altman EM, Smith SC Jr., Alpert JS, et al. ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation. 2004;110:588-636.

Anderson JL, Adams CD, Antman EM, et al. ACC/AHA Guidelines for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). Circulation. 2007;116:803-877.

Smith SD Jr., Blair SN, Bonow RD, et al. AHA/ACC Guidelines for Preventing Heart Attack and Death in Patients with Atherosclerotic Cardiovascular Disease: 2001 Update: A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology. Circulation. 2001;104:1577-1759.

Cayley, Jr WE. Diagnosing the cause of chest pain. Am Fam Physician. 2005;72:2012-2021.