Chest Pain: Causes

What causes chest pain?

Chest pain is caused by a variety of mild to serious disorders, diseases or conditions. Chest pain can result from infection, infarction, inflammation, trauma, malignancy, and other abnormal processes. While many cases of chest pain are due to problems with the heart, chest pain can also be due to respiratory diseases, problems with digestion, anxiety disorders, or a pulled muscle or tendon. In children, chest pain is usually not caused by a heart attack, but may be caused by a serious congenital heart condition or birth defect.

Life-threatening cardiovascular causes of chest pain

Chest pain can arise from problems with the structures surrounding the heart and the heart itself including:

• Aortic dissection

• Cardiac arrhythmias (irregular heart rhythms) 

• Congenital cardiac anomalies and disorders and birth defects, such as coarctation of the aorta and aortic valve stenosis

• Congestive heart failure

• Coronary artery disease (heart disease) including coronary artery spasm or angina due to atherosclerosis (hardening and narrowing of the arteries)

• Endocarditis (inflammation or infection of the inner lining of the heart)

• Heart attack

• Mitral valve prolapse and other heart valve problems

• Pericarditis (inflammation or infection of the lining that covers the heart)

Serious or life-threatening lung-related causes of chest pain

Chest pain can also be caused by serious problems with the respiratory system including:

• Asthma

• Bronchitis

• Chronic obstructive pulmonary disease (COPD)

• Pleurisy (inflammation of the lung lining)

• Pneumonia

• Pneumothorax or hemothorax (collapsed lung or blood around the lung)

• Pulmonary edema

• Pulmonary embolism

• Pulmonary hypertension

Digestive system-related causes of chest pain

Chest pain can arise from gastrointestinal problems including:

• Achalasia (disorder of the esophagus)

• Barrett’s esophagus (abnormal lining of the esophagus caused by stomach acid)

• Heartburn

• Esophageal spasm

• Gallbladder conditions, such as cholecystitis (inflammation of the gallbladder) and gallstones

• Gastritis

• Gastroesophageal reflux disease (GERD)

• Hiatal hernia (abnormal movement of the stomach into the chest)

• Pancreatitis and other pancreas conditions

• Peptic ulcer

Other causes of chest pain

Other causes of chest pain include psychological and inflammatory conditions:

• Anxiety attack

• Chest injury or trauma, such as rib fracture or a bruised chest

• Costochondritis (inflammation of the ribs and breastbone)

• Pulled chest wall muscle (muscle strain)

• Shingles

What are the potential complications of chest pain?

The complications of untreated or poorly controlled chest pain vary depending on the underlying disease, disorder or condition. Any kind of chest pain, whether it occurs alone or is accompanied by other symptoms, should be evaluated by your doctor or health care provider. Once the underlying cause is identified, following the treatment plan you and your health care provider develop specifically for you will minimize the risk of complications of serious or life-threatening underlying causes of chest pain including:

• Cardiac arrest

• Cardiac arrhythmias (abnormal heart rhythm)

• High carbon dioxide levels and acidosis

• Low oxygen levels

• Respiratory failure and respiratory arrest

• Sepsis

• Shock