Causes of Chest Pain

Causes of Chest Pain

Chest pain has many possible causes, all of which deserve medical attention. The causes of chest pain fall into two major categories cardiac and noncardiac causes.
Cardiac causes
Heart attack. A heart attack is a result of a blood clot that's blocking blood flow to your heart muscle.
Angina. Atherosclerotic plaques, containing cholesterol and other substances, can build up in the arteries that carry blood to your heart, narrowing them and temporarily restricting blood flow to your heart, especially during times of exertion. Restricted blood flow to your heart can cause recurrent episodes of chest pain — angina pectoris, or angina (pronounced an-JI-nuh or AN-juh-nuh).
Other cardiac causes. Other problems that can cause chest pain include inflammation of the sac surrounding your heart (pericarditis), a short-lived condition often related to a viral infection.
A rare, life-threatening condition called aortic dissection involves the main artery leading from your heart your aorta. If the inner layers of this blood vessel separate, forcing blood flow between them, the result is sudden and tearing chest and back pain. Aortic dissection can result from a sharp blow to your chest or develop as a complication of uncontrolled high blood pressure.
Coronary spasm, also known as Prinzmetal's angina, can cause varying degrees of chest discomfort. In coronary spasm, coronary arteries — arteries that supply blood to the heart — go into spasm, temporarily closing down blood flow to the heart. Spasm of the coronary arteries may occur spontaneously or be triggered by a stimulant, such as nicotine or caffeine. Coronary artery spasm, which tends to cause episodes of chest pain, can occur with activity or at rest. It may coexist with coronary artery disease — a buildup of plaques in the coronary arteries.
Other possible heart-related conditions that can cause chest pain are metabolic syndrome and endothelial dysfunction.
Noncardiac causes
Many conditions unrelated to your heart can cause chest pain. These include:
Heartburn. Stomach acid that washes up from your stomach into the tube (esophagus) that runs from your throat to your stomach can cause heartburn — a painful, burning sensation behind your breastbone (sternum).
Panic attack. If you experience periods of intense fear accompanied by chest pain, rapid heartbeat, rapid breathing (hyperventilation), profuse sweating and shortness of breath, you may be experiencing a panic attack — a form of anxiety.
Pleurisy. This sharp, localized chest pain that's made worse when you inhale or cough occurs when the membrane that lines your chest cavity and covers your lungs becomes inflamed. Pleurisy may result from a wide variety of underlying conditions, including pneumonia and, rarely, autoimmune conditions, such as lupus. An autoimmune disease is one in which your body's immune system mistakenly attacks healthy tissue.
Costochondritis. In this condition — also known as Tietze's syndrome — the cartilage of your rib cage, particularly the cartilage that joins your ribs to your breastbone, becomes inflamed. The result is chest pain when you push on your sternum or on the ribs near your sternum.
Pulmonary embolism. This cause of chest pain occurs when a blood clot becomes lodged in a lung (pulmonary) artery, blocking blood flow to lung tissue. It's rare for this life-threatening condition to occur without preceding risk factors, such as recent surgery or immobilization.
Other lung conditions. A collapsed lung (pneumothorax), high blood pressure in the arteries carrying blood to the lungs (pulmonary hypertension) and asthma also can produce chest pain.
Sore muscles. Chronic pain syndromes, such as fibromyalgia, can produce persistent muscle-related chest pain.
Injured ribs or pinched nerves. A bruised or broken rib, as well as a pinched nerve, can cause chest pain.
Swallowing disorders. Disorders of the esophagus, the tube that runs from your throat to your stomach, can make swallowing difficult and even painful. One type is esophageal spasm, a condition that affects a small group of people with chest pain. When people with this condition swallow, the muscles that normally move food down the esophagus are uncoordinated. This results in painful muscle spasms.
Another swallowing disorder that also affects a small group of people with chest pain is achalasia (ak-uh-LA-zhuh). In this condition, the valve in the lower esophagus doesn't open properly to allow food to enter your stomach. Instead, food backs up into the esophagus, causing pain.
Shingles. This infection of the nerves caused by the chickenpox virus can produce pain and a band of blisters from your back around to your chest wall.
Gallbladder or pancreas problems. Gallstones or inflammation of your gallbladder (cholecystitis) or pancreas can cause acute abdominal pain that radiates to your chest.
Cancer. Rarely, cancer involving the chest or cancer that has spread from another part of the body can cause chest pain.