12 Causes of Chest Pain: Understanding the Anguish Behind Your Ribcage

Chest pain can be a frightening symptom. For many of us, the first association is a heart attack. But chest pain is not always related to the heart – in fact, there are numerous potential causes, some of which can be managed with simple lifestyle changes, while others require medical intervention. In this comprehensive guide, we explore 12 significant causes of chest pain, shedding light on their symptoms, potential severity, and what to do next.

1. Heart Disease and Heart Attacks

The most widely known cause of chest pain is heart disease. When plaque buildup or a blood clot in an artery blocks blood flow to the heart, a heart attack can occur, leading to severe chest discomfort or pain. This pain can be described as a heaviness, tightness, pressure, burning, or sometimes, a crushing sensation at the center or left side of the chest.

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Recognizing Symptoms

Heart attack symptoms can vary between individuals, but common signs include:

  • Chest discomfort or pain
  • Pain or discomfort in one or both arms, the back, neck, jaw, or stomach
  • Shortness of breath
  • Cold sweats, nausea, and lightheadedness

Immediate Action

Don’t ignore these symptoms. Seek immediate medical attention. Call emergency services if you suspect you or someone else is having a heart attack.

2. Angina

Angina refers to chest pain or discomfort resulting from insufficient blood and oxygen supply to the heart muscle. It can feel like pressure or a squeezing pain in your chest. It can also feel like indigestion. Angina isn’t a disease; it’s a symptom of an underlying heart problem, usually coronary artery disease.

Types of Angina

  • Stable angina: Caused by physical exertion or stress, it follows a pattern over time.
  • Unstable angina: Occurs more frequently and typically lasts longer. It’s unpredictable and can be a signal for an impending heart attack.
  • Variant angina (Prinzmetal’s angina): This type is rare and usually occurs at rest.


Stable angina is usually managed with medication. Unstable angina, being a serious condition, requires immediate medical attention.

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3. Gastroesophageal Reflux Disease (GERD)

GERD is a chronic digestive disease that occurs when stomach acid or, occasionally, stomach content, flows back into your esophagus, causing irritation. This can lead to heartburn, which is a burning sensation behind your sternum (the long flat bone that runs down the center of the chest), that can mimic the pain of a heart attack.

Managing GERD

Most cases of GERD can be relieved through diet and lifestyle changes. Over-the-counter antacids can also offer relief; in severe cases, prescription medications may be necessary.

When to See a Doctor

If you’re experiencing severe chest pain and you think you have GERD, consult a physician immediately to ensure you’re not mistaking heart-related pain for GERD symptoms.

4. Panic Attacks

Panic attacks can cause the sudden onset of intense fear or anxiety accompanied by physical symptoms, such as shortness of breath, heart palpitations, chest pain, and dizziness. Chest pain due to panic attacks can often be sharp and stabbing, increasing the feeling of doom or the sense of a heart problem.

Differentiating Symptoms

Panic attacks are usually brief, often lasting less than ten minutes. They can occur in response to stressors or can happen unexpectedly.

Seeking Help

If you experience panic attacks, seek help from a mental health professional. Various therapies, and in some cases, medications, can be beneficial.

5. Costochondritis

Costochondritis refers to the inflammation of the cartilage linking a rib to the breastbone (sternum). The pain of costochondritis can be very similar to a heart attack. It may be tied to physical exertion or an upper respiratory infection.


The pain will typically be sharp and located along the upper chest wall. It can also radiate to the back or the abdomen.


Treatment usually includes nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate the pain and inflammation. In severe cases, physical therapy may be recommended.

6. Pericarditis

Pericarditis refers to the inflammation and irritation of the pericardium, which is the thin sac-like membrane that envelops the heart. This condition can cause sharp, stabbing pain in your chest that worsens when you breathe and lies down.

Diagnosis and Treatment

Doctors can diagnose pericarditis based on symptoms, medical history, and diagnostic tests. Treatment involves rest and medications to reduce inflammation and treat symptoms.

7. Hiatal Hernia

A hiatal hernia happens when the upper portion of the stomach protrudes through the significant muscle that divides the abdomen and chest, known as the diaphragm. Chest pain can result from the acidic stomach contents moving up into the esophagus.

Recognizing the Pain

Hiatal hernia pain can be similar to a heart attack, especially when it’s severe. However, it can also be a cause of chronic chest discomfort.


Refraining from large meals and not lying down or bending over after a meal can help manage symptoms. Over-the-counter medications can also help neutralize stomach acid.

8. Pneumonia

Pneumonia is an infectious condition that triggers inflammation in either one or both lungs. Chest pain can occur when the fluid buildup in the infected areas causes the lungs to work harder, producing a sharp, stabbing pain when breathing deeply or coughing.

Symptoms and Diagnosis

In addition to chest pain, symptoms of pneumonia can include fever, chills, cough, and shortness of breath. A diagnosis is typically made using a combination of physical signs, blood tests, and imaging tests.


Pneumonia is often treated with antibiotics. Over-the-counter pain relievers can help manage symptoms until the infection clears.

9. Lung Problems

There are various lung conditions that can cause chest pain, ranging from mild to severe. Some of the causes include asthma, bronchitis, and chronic obstructive pulmonary disease (COPD).

Chest pain due to lung problems often comes with additional respiratory symptoms. This may include wheezing, coughing, and, in some cases, difficulty breathing.

Seeking Assistance

If you suspect a lung problem, consult a healthcare professional. A proper diagnosis will dictate the most effective form of treatment, which can include medications, oxygen therapy, and lifestyle changes.

10. Rib Fracture

A broken rib often results from a direct blow to the chest. This can cause severe chest pain, especially when breathing deeply or moving.

Recognizing a Fractured Rib

The pain of a rib fracture is typically severe and localized to the area of the break. You may hear a cracking sound at the time of the injury, and the area may be tender to the touch.

Treatment and Recovery

A fractured rib usually heals on its own within six weeks. Over-the-counter pain relievers can help manage discomfort, and in severe cases, your doctor may recommend stronger pain medications or a brace to limit movement.

11. Shingles

Shingles is a painful skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox. Chest pain due to shingles can be intense, burning, and stabbing, and may occur before any rash is present.

Symptoms and Treatment

If you’ve had chickenpox, you can get shingles. Symptoms can include tingling, itching, or burning before the rash appears. Antiviral medications can help manage pain and speed recovery.

12. Musculoskeletal Injuries

Injuries to the muscles, tendons, and ligaments in the chest can be caused by overuse, trauma, or improper lifting. The pain can vary from a dull ache to a sharp, stabbing sensation.

Understanding Muscle Pain

Musculoskeletal chest pain often worsens with movement of the upper body, like lifting or twisting. It may also be tender to the touch or feel better with rest or over-the-counter pain relievers.

Recovery Process

Muscle injuries often heal with time, rest, and the use of ice or heat to manage pain and promote healing. In some cases, physical therapy may be beneficial for recovery.

Understanding the various causes of chest pain can help you identify the source of your discomfort and take the appropriate actions to seek relief. If you experience chest pain, especially if it’s severe or persistent, don’t hesitate to seek medical help. In an emergency, always call 911 or your local emergency number. Remember that even if the cause of your chest pain turns out to be benign, it’s always better to be safe than sorry when it comes to your health.

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This site provides educational information only. It is important not to depend on any content here in place of professional medical advice, diagnosis, or treatment. Similarly, it should not replace professional counseling care, advice, diagnosis, or treatment. If you have any health concerns or questions, always seek guidance from a physician or another healthcare professional.