Chest pain has many causes. Life-threatening causes include heart attack, angina, aortic dissection, perforated viscus, pulmonary embolism, collapsed lung, and cocaine abuse. Non life-threatening causes of chest pain include pericarditis, shingles, pneumonia, costochondritis, and esophageal conditions. Symptoms, diagnosis, treatment, and prevention are specific to the cause of the chest pain.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
If you are having severe
pain, crushing, squeezing, or pressure in your chest that lasts more than a few
minutes, or if the pain moves into your neck, left shoulder, arm, or jaw, go immediately to a hospital emergency department. Do not drive yourself. Call 911 for emergency transport.
Chest pain is one of the most frightening symptoms a person can have. It is sometimes difficult even for a doctor or other medical professional to tell what is causing chest pain and whether it is life-threatening.
Any part of the chest can be the cause of the pain including the heart, lungs, esophagus, muscle, bone, and
Because of the complex nerve distribution in the
body, chest pain may actually originate from another part of the body.
The stomach or other organs in the belly (abdomen), for example, can cause chest pain.
Potentially life-threatening causes of chest pain are as follows:
Heart attack (acute
myocardial infarction): A heart attack occurs when blood flow to the arteries that supply the heart (coronary arteries) becomes blocked. With decreased blood flow, the muscle of the heart does not receive enough oxygen. This can cause damage, deterioration, and death of the heart muscle.
is chest pain related to an imbalance between the oxygen demand of the heart
and the amount of oxygen delivered via the blood. It is caused by blockage or
narrowing of the blood vessels that supply blood to the heart. Angina is
different from a heart attack in that the arteries are not completely blocked,
and it causes little or no permanent damage to the heart. "Stable" angina
occurs repetitively and predictably while exercising and goes away with rest.
"Unstable" angina results in unusual and unpredictable pain not relieved
totally by rest, or pain that actually occurs at rest.
Aortic dissection: The aorta is the main artery that supplies blood to the
vital organs of the body, such as the brain, heart, kidneys, lungs, and
intestines. Dissection means a tear in the inner lining of the aorta. This can
cause massive internal bleeding and interrupt blood flow to the vital
Pulmonary embolism: A pulmonary embolus is a blood clot in one of
the major blood vessels that supplies the lungs. It is a potentially
life-threatening cause of chest pain but is not associated with the heart.
Often called a collapsed lung, this condition occurs when air enters the
saclike space between the chest wall and the lung tissue. Normally, negative
pressure in the chest cavity allows the lungs to expand. When a spontaneous
pneumothorax occurs, air enters the chest cavity. When the pressure balance is
lost, the lung is unable to re-expand. This cuts off the normal oxygen supply
in the body.
Perforated viscus: A perforated viscus is a hole or tear in the wall of any area of the gastrointestinal tract. This allows air to enter the abdominal cavity, which irritates the diaphragm, and can
cause chest pain.
Cocaine-induced chest pain:
Cocaine causes the blood vessels in the body to constrict. This can decrease blood flow to the heart, causing chest pain. Cocaine also accelerates the progression of atherosclerosis, a risk factor for a heart attack.