Chest Pain

Chest pain is pain experienced by an individual because of various underlying medical causes. Various medical conditions, ranging from minor issues like gastritis to life-threatening conditions such as a heart attack can present with chest pain. Chest pain can vary from mild to the severe aching or throbbing type of pain. It can also be accompanied by other symptoms like shortness of breath, dizziness, nausea, sweating, and palpitations.

Various heart-related issues such as angina, heart attack, pericarditis, Lung-related issues such as pneumonia, pulmonary embolism, Gastrointestinal issues such as gastroesophageal reflux disease, esophagitis, or peptic ulcer disease, Musculoskeletal issues such as costochondritis or chest wall injuries all present with chest pain.

Chest pain should not be neglected as it can present various life-threatening medical issues which may lead to death. Extra care should be taken if chest pain is accompanied by other symptoms such as shortness of breath, sweating, or dizziness. It is important to diagnose the underlying cause and ensure appropriate treatment.

Chest Pain: Causes

Chest pain can be presented by various medical conditions. The important causes of chest pain include −

  • Angina, a myocardial infarction (heart attack), pericarditis (inflammation of the lining surrounding the heart), on aortic dissection are all heart-related conditions (tear in the aorta)

  • Lung-related conditions such as pleurisy, pneumonia, or pulmonary embolism (blockage in the lung artery) (inflammation of the lining surrounding the lung)

  • Gastrointestinal conditions such as peptic ulcer disease, esophagitis (esophageal inflammation), and gastroesophageal reflux disease (GERD)

  • Injuries to the chest wall or musculoskeletal conditions such as costochondritis (inflammation of the cartilage connecting the ribs to the breastbone)

  • Neurobehavioral issues like Panic or anxiety attacks can also present with chest pain.

Chest Pain: Symptoms

The chest pain can vary depending on the system of the body affected. The associated symptoms vary depending on the system involved.

  • Cardiac chest pain − typically feels like a pressure or tightness in the chest that can radiate to the arms, neck, jaw, back, or stomach. Cardiac chest pain is usually associated with shortness of breath, sweating, nausea or vomiting, dizziness, or light-headedness.

  • Chest pain related to lung diseases − usually presents as a sharp, stabbing pain that increases with deep breathing or coughing. Associated symptoms of Shortness of breath, Rapid breathing, Cough, Wheezing, Cyanosis.

  • Gastrointestinal chest pain − Chest pain related to gastrointestinal issues typically presents as a burning or gnawing sensation in the chest. Associated symptoms such as nausea or vomiting, bloating or gas, indigestion, regurgitation of food.

  • Musculoskeletal chest pain − Typically presents as a dull ache or a sharp pain that increases on with movement or pressure. Associated symptoms such as tenderness or swelling in the affected area, difficulty moving or using the affected area, muscle spasms or cramping.

Chest Pain: Risk Factors

The important risk factors of chest pain include −

  • Age − Older age group people are more at increased risk of developing various medical issues hence chest pain is more common in them presenting the underlying cause.

  • Family history − Chest pain is more likely to occur in people who have a family history of heart disease or other disorders that are associated with it, such as high blood pressure or high cholesterol.

  • Smoking − Smoking affects blood vessels and raises the risk of heart disease and atherosclerosis.

  • High blood pressure − High blood pressure increases the risk of chest discomfort and heart disease by causing artery damage and atherosclerosis.

  • High cholesterol − Low-density lipoprotein (LDL), or "bad" cholesterol, levels that are too high can increase the risk of atherosclerosis causing various heart diseases.

  • Diabetes − Patients with diabetes are more prone to develop various heart-related problems.

  • Obesity − Being overweight increases the risk of getting diabetes, high blood pressure, and other illnesses that can all lead to the onset of chest pain.

  • Physical inactivity − Being sedentary increases the chance of developing diseases including high blood pressure, high cholesterol, and obesity, which can cause chest pain.

  • Stress − Long-term stress raises the chance of developing illnesses including high blood pressure, which can lead to chest pain and heart disease.

Chest Pain: Diagnosis

The underlying cause presenting with chest pain should be diagnosed. Some of the methods required to diagnose the underlying cause include −

  • Medical history of the type of chest pain, associated symptoms along with the chest pain, and family history of any medical issues should be asked. History of any events causing panic attacks should also be enquired about.

  • Clinical examination to rule out any underlying illnesses should be done.

  • Electrocardiogram (ECG An ECG is a test that assesses the heart's electrical activity. It helps in the early detection of anomalies like a heart attack or an arrhythmia that may be the source of chest pain.

  • X-ray of the chest − An X-ray of the chest can help identify any anomalies in the heart, lungs, or other structures.

  • Blood tests − Blood tests can be used to diagnose specific illnesses, such as a heart attack or pulmonary embolism, that may be causing chest pain.

  • An echocardiogram and stress test can be helpful in patients having diseases with the heart

  • CT or MRI scans  These imaging examinations can give clear pictures of the chest and help find any anomalies that might be the source of any chest pain.

  • Ultrasound of the abdomen is necessary for patients with gastric issues. Endoscopy should be carried out if necessary

Chest Pain: Treatment

The treatment of chest pain depends on the underlying cause of the chest pain.

  • If the chest pain is related to a heart attack emergency management should be done and medication to dissolve blood clots, unblock clogged arteries, and pain relievers may be part of the treatment.

  • Angina mainly presents with chest pain, treatment options for this include lifestyle modifications like stopping smoking, consuming a heart-healthy diet, and increasing physical exercise in addition to drugs to enlarge blood vessels and enhance blood flow.

  • Chest pain brought on by worry or a panic attack may be treated with relaxing exercises like deep breathing, meditation, or cognitive-behavioral therapy (CBT).

  • Therapy for pneumonia or other lung conditions may include oxygen therapy to help with breathing as well as antibiotics or other treatments to treat the underlying illness.

  • Gastrointestinal conditions − Gastrointestinal conditions like acid reflux or heartburn might contribute to some types of chest pain. Prescription or over-the-counter drugs to lower acid may be used as part of the treatment.

Chest Pain: Prevention

The prevention of chest pain can be done by preventing the underlying medical diseases causing chest pain. Some of the measures include −

  • Following a healthy balanced diet

  • Regular physical activity

  • Management of stress by various relaxation techniques, such as meditation, deep breathing, or regular exercise, can help reduce this risk.

  • Avoid smoking and drinking

  • Control of other health conditions such as high blood pressure, diabetes, and high cholesterol


Chest pain is pain in the chest area that occurs because of underlying medical issues such as diseases related to the heart, lungs, gastrointestinal system, neuromuscular system, and neurobehavioral disorders like panic attacks. Chest pain varies depending on the system affected.

Diagnosis of the underlying disease and treating the underlying cause can reduce chest pain. Preventive measures like maintaining a balanced diet, regular exercises, avoiding smoking and alcohol, control of other medical issues like diabetes, blood pressure, and high cholesterol can reduce the occurrence of the underlying illnesses that cause chest pain.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 13-Mar-2023


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