HCA Midwest Health - December 01, 2018

Let's be clear. No one will ever fault you for calling 911 with chest pain. It's the safe thing to do. According to the American College of Emergency Physicians, chest pain is one of the top reasons people visit the ER. That's a good thing. Minutes save lives in heart attack situations, and any time you have chest pain, it should be evaluated by a medical professional. But did you know there are many causes of chest pain? According to some studies, less than a quarter of people who go to the ER with chest pain are diagnosed with a heart attack. Some causes of chest pain are relatively minor, while others – even aside from heart attacks – can signal something serious. Let's take a look at 15 reasons why your chest might hurt.

When it's your heart...but not a heart attack


Angina is chest pain that occurs when blood flow to the heart is blocked. This is often caused by plaque build-up on the walls of the arteries carrying blood to your heart. Although it doesn't leave lasting damage like a heart attack, angina can be a warning sign of heart problems. Angina can feel like pressure or squeezing with pain that may radiate to the shoulders, arms, back or neck. Stable angina flares up during exercise, excitement or emotional upset, but is relieved by rest. Unstable angina can appear at any time. It is more serious, indicating you're at greater risk for a heart attack.


Myocarditis is inflammation of the heart muscle, most often caused by a virus. It can produce mild chest pain, pressure, rapid heartbeat, shortness of breath and sometimes signs of infection such as fever, muscle aches.


Pericarditis is inflammation of the tissue surrounding the heart. It may be caused by viral or bacterial infection, illness, injury or even reaction to surgery or medication. Pericarditis can feel like a sharp, stabbing pain in the center or left side of your chest that gets worse when you take a deep breath or lie down. It may be relieved by leaning forward.

Aortic dissection

Aortic dissection is a rare, but life-threatening condition when a tear develops in the wall of the aorta, forming a new channel between the inner and outer layers of the wall and allowing blood to leak or spill out into that channel. It can feel like a sudden, sharp and continuous pain in your chest and upper back. It can also cause pain in the arms and difficulty breathing. The symptoms are so sudden and severe that most people have little doubt help is needed right away.

Chest Pain from Lung Issues


Pleurisy is inflammation or swelling of the lung lining, most commonly caused by a viral infection. It can feel like a sharp pain when you sneeze, cough or breathe. The pain may spread throughout your body and turn into a constant ache.

Airway problems (Asthma, COPD)

Asthma and COPD both (for different reasons) cause inflammation of your airways making it tough to breathe. It can feel like tightness in the chest and cause wheezing or coughing.

Pulmonary embolism

A pulmonary embolism is a blood clot that becomes stuck in one of the arteries in the lungs. This is a medical emergency that needs to be treated right away. It can feel like a sharp pain that can be gradual or sudden and becomes worse with physical activity or exertion. Sometimes, the pain is accompanied by fast or irregular heartbeat.

Collapsed lung

A collapsed lung occurs when air gets in the space between your ribs and lungs. This puts pressure on the lungs and doesn’t allow them to expand. A sign of a collapsed lung is chest pain that begins suddenly and can last for several hours. Breathing can become painful and more difficult.

Chest Pain from Digestive Issues

Acid reflux (heartburn)

This is when food or acid backs up from the stomach and irritates the lining of the throat. Other symptoms can include a sour taste in the mouth, trouble swallowing and a burning sensation that can become worse when lying down. Learn how to tell heartburn from a heart attack.

Esophagus problems

The esophagus can become inflamed due to acid reflux or conditions such as allergies or infection. This can cause a burning sensation and discomfort when swallowing.

Pancreas or gallbladder problems

Gallstones or inflammation of the gallbladder or pancreas can cause upper belly pain that radiates to the chest.

Bones or muscle chest pain

Muscle strain

Exercise, heavy lifting or even hard coughing can inflame the muscles and tendons around the chest, causing pain. Chest pain due to muscle strain usually gets worse with movement (including movement from breathing).

Rib bruising or fracture

An injury to the ribcage such as broken or cracked rib can cause pain when breathing. The pain is generally confined to one area, and is likely sore when you press on it.

Other Causes of Chest Pain

Panic or anxiety attack

A panic attack is a sudden and intense feeling of fear or panic that can trigger physical symptoms. It can be characterized by a stabbing, intense pain generally in the middle of the chest, intense anxiety, shortness of breath and/or heart palpitations. Learn how to tell a panic attack from a heart attack.

Shingles (Herpes Zoster)

Shingles is an infection caused by the chickenpox virus that produces a painful rash or blisters. Chest pain that can feel like a burning, numbness or tingling may precede the rash, often leading people to think it may be a heart or lung problem.

Emergency Care in Kansas City

If you have undiagnosed chest pain, don’t delay. Chest pain should always be evaluated by a healthcare provider. HCA Midwest Health offers 11 KC emergency room locations and the area's largest network of accredited chest pain centers.

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