Experiencing chest pain is scary and shouldn’t be ignored. At best, it’s uncomfortable; at worst, it’s a warning sign. Chest pain is also fairly common. Non-traumatic chest pain is the second-most frequent cause of emergency department visits among adults in the US, according to a 2016 study in JAMA Internal Medicine.
With so many potential causes of chest pain (which we’ll get into in a bit), how do you know what you’re dealing with? Is it heart-related or something else?
As someone who has struggled with chest pain on and off for years, with a few guesses at the culprit – anxiety, asthma, costochondritis – I know, to some degree, what that fear is like. I reached out to cardiologists for their input on what to look for.
When chest pain might be a heart issue
One thing to monitor is when the pain arises.
“Chest discomfort that is heart-related is usually described as a chest discomfort that is worse with exertion,” says Dr. Estelle Jean, a cardiologist from MedStar Montgomery Medical Center in Olney, Maryland. “Patients typically describe the chest discomfort as tightness, pressure, heaviness, squeezing, a band-like sensation or heartburn.” She added the pain is usually gradual in both the onset and offset.
If the chest pain is secondary to blockages of heart arteries, you may also notice other signs. For example, the pain “may radiate to the left arm, shoulder or jaw, and can be associated with other symptoms such as trouble breathing, lightheadedness, sweating or nausea and vomiting,” says Dr. Adriana Quinones-Camacho, a cardiologist and the chief of medicine at NYU Langone Health’s Manhattan campus.
Both Jean and Quinones-Camacho agreed that rest is crucial – along with talking to a doctor, of course. “Any chest pain symptoms should be taken very seriously and fully evaluated by a health care provider,” Quinones-Camacho says.
What are other causes of chest pain, and what can relieve them?
Let’s start with what chest pain that’s not related to the heart usually looks like. Jean says it’s “typically described as a sharp pain that is worse with deep breathing or coughing, pain localised with one finger, pain worse with movement or palpation, and fleeting pains lasting a few seconds or less.”
Many things can cause chest pain, but here are some of the common ones experts see:
Acid reflux
Gastroesophageal reflux disease (GERD), or acid reflux, is when stomach acid comes back up your oesophagus. (Yup, it’s as bad as it sounds.) You may notice heartburn after eating, difficulty swallowing and coughing. Jean suggests treating GERD with antacids, such as Tums or Rennie.
Asthma
Asthma is a condition where your airways narrow and produce extra mucus. Signs include wheezing while exhaling, shortness of breath and coughing. If you have asthma, talk to your doctor about getting an inhaler if you don’t already have one (and make sure you get a new one once your current one expires).
Anxiety
Like many mental illnesses, anxiety can cause physical issues, such as chest pain. Besides worrying, people with generalised anxiety disorder may also overthink, struggle with uncertainty and be unable to relax or concentrate. Both psychotherapy and anti-anxiety medication can help, Jean says.
“Strategies to reduce stress can include meditation, yoga, sleeping at least 7 to 8 hours at night, eating a heart-healthy diet and engaging in regular exercise,” she adds. Heart-healthy foods that cardiologists eat include fruit, vegetables, lean meat and whole grains.
Muscle strain
Skipping warm-ups before exercising, contact injuries, lifting things while twisting your body and muscle fatigue can all cause muscle strain.
Pay attention to any bruising, pain while breathing, swelling and difficulty moving. If you faint, get dizzy, vomit, have a fever, get sleepy or struggle to breathe after, go to the emergency room immediately. Otherwise, Quinones-Camacho says the issue should resolve on its own.
Among the other potential causes of chest pain are chest wall issues, stomach ulcers, a pulmonary embolism and pneumonia. Getting your doctor’s input on your specific case is important. At the very least, consider calling a nurse support line. Insurance companies often offer this as part of their benefits.
Remember: chest pain can be life-threatening, even if it doesn’t seem like it at first. Seeing a physician as soon as possible is vital.