11 causes of chest pain that aren’t a heart attack

When you feel chest pain, your thinking goes to: “Oh no, am I having a heart attack?” And it’s true that acute chest pressure or tightness is the most prevalent symptom of a heart attack. However, many other kinds of chest pain can create similar forms of discomfort, according to specialists, and determining what you’re dealing with can be difficult.

“The idea is to urge our patients — and all of us — to check in with our bodies and notice and pay attention when something doesn’t seem right,” Dr. Anuradha Lala, an advanced heart failure and transplant cardiologist at The Mount Sinai Hospital, tells TODAY.com.

Because new instances of chest pain might indicate a major illness, such as a heart attack, it’s always crucial to get medical assistance – especially if your discomfort persists and is extremely severe, according to Lala. However, this does not always imply that the underlying reason is fatal.

Here’s what to look out for, as well as some hidden reasons of chest discomfort that aren’t a heart attack.

First, learn the symptoms of a heart attack.
Dr. Ron Blankstein, a preventive cardiology expert at Brigham and Women’s Hospital and a professor of medicine at Harvard Medical School, tells TODAY.com that different people will have various symptoms after a heart attack.

“However, by far the most prevalent symptom would be chest pain,” he explains. Furthermore, physicians choose the term “discomfort” rather than “pain” since the experience does not always feel unmistakably severe, according to Blankstein.

It may feel like tightness, heaviness, or pressure in the chest for some people. However, the pain is often considerable. It’s also usually permanent, and it doesn’t change when you shift positions, according to Blankstein. The discomfort may also radiate to the shoulder, neck, or jaw.

Along with chest pain, some patients may experience other symptoms that indicate a heart attack. Women, in particular, may experience extreme perspiration, vomiting, or nausea, according to Blankstein.

“It’s also worth considering who the person experiencing the chest discomfort is,” Dr. Seth Martin, cardiologist and associate professor of medicine at Johns Hopkins Hospital, tells TODAY.com.

If a person experiencing chest pain also has known risk factors for a heart attack (such as high blood pressure, high cholesterol, diabetes, or smoking), “the more likely it is that it might be a heart attack or this discomfort could be caused to a blockage in the heart arteries,” Martin notes.

Causes of chest discomfort that aren’t caused by a heart attack

Pericarditis

According to Blankstein, pericarditis may be the cause of chest discomfort that is positional, meaning that it feels better when you sit up or lie down.

This illness develops when the pericardium, the tissue that lines the heart, becomes inflamed, which can happen as a result of a viral infection.

“That can produce a strong chest ache that can travel to your left arm or shoulder,” Lala explains. “It might be harsher while you’re lying down or taking deep breaths.”

Coronary artery dissection

A coronary artery dissection is an uncommon but deadly disorder that causes significant chest discomfort when one of your arteries tears.

According to Lala, you can even have a rip in the aorta, the main blood vessel in your body that delivers blood from the heart to the rest of your body.

According to Blankstein, this generates an immensely severe ripping chest agony that might spread to the back.

Lala adds: “That’s a really powerful agony that feels like something is ripping inside of you. The discomfort might be felt in your back as well as between your shoulder blades and your chest.”

Aortic dissection is more common in persons with high blood pressure and specific connective tissue diseases that make the aorta more vulnerable to rip, according to Blankstein.

 

Infections of the lungs

Pleuritic discomfort is defined as “chest ache that worsens as you breath deeply,” according to Martin. Pleuritic pain can be caused by pericarditis, but this form of discomfort is usually associated with lung problems, he explains.

According to the Mayo Clinic, respiratory infections can cause inflammation and swelling of the tissue lining the lungs, a disease known as pleurisy. On inhalation, this usually causes acute chest discomfort.

pulmonary embolism

A pulmonary embolism is a blood clot that has found its way to the arteries that connect the heart to the lungs, causing chest pain and shortness of breath, according to Blankstein.

“It can cause chest discomfort, difficulty breathing, low oxygen levels, and a rapid heart rate,” Martin explains.

The potentially fatal illness frequently begins elsewhere in the body. According to Blankstein, it usually breaks off of a blood clot that begins in one of the legs, which may be enlarged.

Asthma

Asthmatics cause the airways to shrink and generate additional mucus, which causes coughing and wheezing and makes breathing difficult, according to the Mayo Clinic.

According to Martin, airway restriction is also “a fairly prevalent cause” of chest tightness and pain. “If you’re detecting wheezing and feel like you’re having an asthma attack, it may be a very plausible explanation for chest pain.”

Muscle strain

Pain that worsens with specific motions or with pressing on certain areas of your chest, according to Blankstein, might signal musculoskeletal difficulties, which can be as simple as a strained muscle.

“If you go to the gym and the next day your chest is uncomfortable, you probably overdid it,” he adds. One telltale symptom is that “you may be able to duplicate some of that discomfort by completing some of the exercises you did at the gym.”

Costochondritis

Costochondritis, which occurs when the cartilage around your ribs gets inflamed, is another probable cause of chest discomfort that you may readily duplicate, according to the Mayo Clinic. And it most typically appears in the sternum, just where a heart attack would appear. It has no definite aetiology, however it might be attributed to physical strain.

“Typically, this form of pain has a distinct feature than heart-related discomfort,” Martin adds. He adds that it’s typically “a harsher or even a shooting sort of pain” that worsens when you push on the spot.

A doctor can generally localise and duplicate that discomfort by gently pressing on the ribs during a physical examination. If this causes the same level of suffering, “it’s a fairly strong signal that that’s where the pain is coming from,” Martin adds.

Heartburn

According to Martin, heartburn is one of the most prevalent causes of chest discomfort. It creates discomfort that is “more of a burning feeling towards the lower region of your chest where it connects with the belly,” he adds.

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According to the Mayo Clinic, this happens when the digestive acid in your stomach finds its way back up your oesophagus, and it usually happens after eating particular foods, large meals, or too close to bedtime.

If you experience regular heartburn, you may have gastroesophageal reflux disease, and you may need prescription medication or other therapies to control your symptoms.

Esophageal spasms or inflammation

Esophageal problems can also cause chest pain and discomfort. According to specialists, this can be caused by food becoming lodged in the oesophagus, inflammation of the esophageal lining, or muscular spasms.

“The oesophagus contains muscle in it, and if that muscle spasms, it can induce chest discomfort,” Martin adds.

In fact, “the symptoms are really difficult to distinguish from cardiac disease,” Blankstein says.

Gallstones, according to the Cleveland Clinic, cause gallbladder inflammation and swelling by interfering with bile flow. Some people have no symptoms of gallstones, but others may have severe discomfort in the affected location.

“Swelling in your gallbladder may make it hurt beneath your ribcage on your right side,” Lala continues, “and you can get right-sided chest discomfort with that.”

Panic attack

Anyone who has experienced a panic attack understands that the symptoms — rapid heart rate, sweating, difficulty breathing, and a sense of impending doom — may make you feel as if you’re dying.

And it’s not uncommon for individuals in the midst of a panic attack to seek emergency treatment, which is the recommended course of action if you suspect you’re suffering a heart attack.

It’s critical to understand this disease because, according to Blankstein, “at times, patients might actually have a racing heart,” but clinicians dismiss their symptoms as anxiety-related.

So, he argues, “the context of what causes your symptoms is critical,” but “it’s not always possible to differentiate one from the other, and when in question, it surely requires a medical review.”

When to seek medical attention:
There are several causes of chest discomfort, and the real cause is frequently not clear even to professionals without further testing. (And this is not a comprehensive list.) According to the specialists, any new chest pain, pressure, tightness, or discomfort is worth getting checked out.

“What you truly worry about is dialing 911 and getting quick medical help when you need to rule out anything catastrophic, like a heart attack or an aortic dissection,” Lala explains.

Experts agree that if your pain is severe, persistent, radiating, or producing additional symptoms, you should dial 911.

Blankstein says physicians at the hospital may do an EKG, a blood test, a treadmill test, or imaging, such as an MRI or CT scan, to establish the origin of your discomfort.

Even if your chest pain isn’t connected to your heart, Martin recommends speaking with your doctor and asking questions to ensure you’re doing all possible to prevent heart disease. Whatever the reason for your chest discomfort, it’s important taking the time to relax and get advice from your doctor.