15 Causes of Chest Pain and How They Are Treated

Author: Nnenna Chiloli, MBBS, MPH

Medical Reviewer: Oke Ikpekpe, MSc (PH) 

Highlights

• Chest pain can be harmless or serious (such as a heart attack or a lung blockage).
• Heart-related causes like heart attack, angina, and aortic dissection need urgent medical care.
• Lung issues like blood clots, infections, or collapsed lung cause chest pain and breathing difficulties.
• Stomach issues like acid reflux or ulcers can feel like heart pain.
• Muscle or bone issues, like costochondritis or strain, cause chest pain (not usually serious).
• Stress and anxiety can cause real chest pain. 
• Get help immediately if you have severe chest pain, pain in the arm/jaw, difficulty breathing, or if it lasts more than 15 to 20 minutes.

Introduction

Have you ever felt a sudden pain in your chest and immediately wondered, “What is wrong? Do I need to get to the hospital right now?” It is completely natural to worry, and while this symptom can be frightening, it's important to know that chest pain has many different causes, some serious and some not. Chest pain is one of the most common reasons people visit their doctor or go to the emergency room.

 About 1 percent of all primary care office visits are for chest pain [1]. Chest pain can feel different for different people. It might be a sharp stabbing sensation, a dull ache, a burning feeling, or a sense of pressure or tightness. It can last for a few seconds or persist for hours. The pain might stay in one spot or spread to your shoulders, arms, neck, jaw, or back.

This article will help you understand the 15 most common causes of chest pain, what each condition is, how it feels, how doctors confirm these conditions, and how they're treated.

Why Should You Never Ignore Chest Pain?

Chest pain should never be ignored because it can be a warning sign of a life-threatening condition that requires immediate treatment. While many causes of chest pain are not dangerous, some conditions, like heart attacks and pulmonary embolism, can be fatal if not treated quickly.

Taking chest pain seriously matters because:

• Time is critical for heart attacks

When a heart attack occurs, blood flow to part of your heart muscle is blocked. Every minute that passes without treatment means more heart muscle is damaged or dies. Quick treatment can restore blood flow, save heart muscle, and save lives.

• Some conditions can be fatal within minutes to hours

Conditions like aortic dissection (a tear in the main artery from your heart) and massive pulmonary embolism ( a large blood clot in your lungs) can cause death very quickly if not diagnosed and treated immediately.

• Early diagnosis prevents complications

Even for less immediately life-threatening conditions like pneumonia, early diagnosis and treatment can prevent serious complications and help you recover faster.

• Chest pain affects quality of life

Heart-related chest pain, even when not dangerous, can significantly impact your daily life, causing anxiety, limiting activities, and leading to repeated emergency room visits. 

Causes of Chest Pain

Chest pain has many possible causes. 

These include: 

• Cardiac (Heart-related) causes

Your heart is located in the centre of your chest, slightly to the left. When something goes wrong with your heart or the blood vessels that supply it, you may feel chest pain. Cardiac causes are among the most serious reasons for chest pain and often require immediate medical attention [2].

1. Heart Attack (Myocardial Infarction)

A heart attack occurs when blood flow to a part of your heart muscle is suddenly blocked, usually by a blood clot in the arteries that supply blood to your heart. Without oxygen-rich blood, that part of the heart muscle begins to die. Classic heart attack pain is often described as:

• Pressure, squeezing, fullness, or pain in the centre or left side of the chest
• Pain that lasts more than a few minutes or goes away and comes back
• Pain that may spread to your shoulders, arms( especially the left arm), back, neck, jaw, or stomach
• Accompanied by shortness of breath, cold sweats, nausea, lightheadedness, or extreme fatigue

However, not everyone experiences the classic symptoms. Some people, especially women, older adults, and people with diabetes, may have atypical symptoms like unusual fatigue, indigestion-like discomfort, or shortness of breath without significant chest pain.

2. Angina

Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. It's usually a symptom of coronary artery disease, where the arteries that supply your heart become narrowed or blocked by fatty deposits called plaque. Angina typically causes:

• Pressure, squeezing, heaviness, or tightness in the chest
• Pain that may spread to the arms, neck, jaw, shoulder, or back
• Symptoms triggered by physical activity, emotional stress, cold weather, or heavy meals

3. Pericarditis

Pericarditis is inflammation of the pericardium (the thin, two-layered sac that surrounds your heart). Viral infections, bacterial infections, autoimmune diseases, heart attack, chest trauma, or certain medications can cause this inflammation. Pericarditis typically causes:

• Sharp, stabbing chest pain, usually in the centre or left side of the chest
• Pain that worsens when you breathe deeply, cough, lie down, or swallow
• Pain that improves when you sit up and lean forward [3]
• May be accompanied by fever, weakness, or palpitations( feeling your heart is racing)

4. Aortic dissection

Aortic dissection is a serious, life-threatening condition where a tear develops in the inner layer of the aorta ( the large blood vessel that carries blood from your heart to the rest of your body) [4]. Blood surges through this tear, causing the inner and middle layers of the aorta to separate (dissect). Aortic dissection is often fatal if the blood-filled channel ruptures through the outer aortic wall.Risk factors include:

• High blood pressure
• Atherosclerosis (hardening of the arteries)
• Connective tissue disorders
• Certain genetic conditions

                        Aortic dissection typically causes:

• Sudden, severe chest or upper back pain, often described as a tearing or ripping sensation
• Pain that may move as the dissection extends along the aorta
• Difference in blood pressure between the right and left arms
• Sudden difficulty speaking, vision loss, or weakness on one side of the body( if dissection affects blood flow to the brain)
• Weak or absent pulse in the arm or leg

.

• Pulmonary (Lung-related) Causes

Your lungs and the tissues surrounding them can also cause chest pain. Lung-related causes of chest pain range from serious conditions requiring immediate treatment to less urgent problems.

5. Pulmonary Embolism

A pulmonary embolism occurs when a blood clot ( usually from the legs or pelvis) travels through your bloodstream and lodges in an artery in your lungs, blocking blood flow. This prevents oxygen from reaching part of your lung tissue and puts strain on your heart. 

Risk factors include:

• Prolonged immobility, such as long flights, bed rest, etc
• Recent surgery
• Cancer
• Pregnancy
• Birth control pills
• Smoking
• Inherited clotting disorders

                         Pulmonary embolism symptoms include:

• sudden, sharp chest pain that worsens with deep breathing or coughing
• Shortness of breath that comes on suddenly
• Rapid heart rate
• coughing, sometimes with bloody mucus
• Lightheadedness or fainting
• Anxiety or a feeling of impending doom

6. Pneumonia 

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing cough, fever, and difficulty breathing. Pneumonia can be caused by bacteria, viruses, or fungi [5].Symptoms include:

• Chest pain that worsens with breathing or coughing
• A cough that may produce mucus that's green, yellow, or bloody
• Fever, sweating, and chills
• Shortness of breath
• Fatigue and weakness
• Nausea, vomiting, or diarrhoea (in some cases)

7. Pleuritis (Pleurisy)

Pleuritis is inflammation of the pleura (the thin, two-layered membrane that surrounds your lungs and lines the inside of your chest cavity). Normally, these layers glide smoothly over each other as you breathe. When they are inflamed, they rub together, causing pain. Viral infections, bacterial infections, pulmonary embolism, autoimmune diseases, or chest trauma can cause pleuritis.The symptoms of pleuritis are:

• Sharp, stabbing chest pain that worsens with breathing, coughing, or sneezing
• Pain that improves when you hold your breath or apply pressure to the painful area
• Shortness of breath
• Cough and fever (if caused by infection)

8. Pneumothorax 

A pneumothorax (collapsed lung) occurs when air leaks into the space between your lungs and chest wall. This air pushes on the outside of your lung, causing it to collapse partially or completely. Pneumothorax can occur spontaneously (especially in tall, thin young men), result from chest trauma, or be a complication of lung disease or medical procedures.

Symptoms of pneumothorax include:

• sudden, sharp chest pain on one side
• Shortness of breath
• Fast breathing
• Chest tightness
• fatigue

9. Pulmonary Hypertension

Pulmonary hypertension is high blood pressure in the arteries that carry blood from your heart to your lungs. This increased pressure makes your heart work harder to pump blood through your lungs, eventually weakening the heart muscle. Pulmonary hypertension can be caused by heart disease, lung disease, blood clots, or other conditions, or it can occur without a clear cause.Early pulmonary hypertension may cause no symptoms. As it progresses, symptoms include:

• Shortness of breath, initially with activity and later at rest
• Chest pain or pressure, especially with exertion
• Fatigue and weakness
• Dizziness or fainting
• Swelling in the ankles, legs, or belly
• Bluish colour on the lips and skin
• Rapid or irregular heartbeat

• Digestive system Causes

        Digestive problems can also cause chest pain because your oesophagus and stomach are located near your heart. This pain can sometimes feel like heart-related chest pain, making it hard to tell the difference.

10. Gastroesophageal Reflux Disease (GERD)

GERD occurs when stomach acid frequently flows back into the oesophagus, the tube that connects your mouth and stomach. This backwash (reflux) irritates the lining of your oesophagus, causing symptoms. GERD is very common and is one of the most frequent causes of non-heart-related chest pain.

GERD typically causes:

• Burning sensation in the chest(heartburn), usually after eating and sometimes at night
• Burning pain that rises from the stomach toward the neck
• Sour or bitter taste in the mouth
• Difficulty swallowing
• Sensation of a lump in the throat
• Long-lasting cough or hoarseness

            The chest pain from GERD can sometimes mimic heart attack pain, which is why it's important to get evaluated.

        11. Peptic Ulcer Diseases

Peptic ulcers are open sores that develop on the inner lining of your stomach (gastric ulcers) or the upper part of your small intestine( duodenal ulcers). They are most commonly caused by infection with Helicobacter pylori bacteria or long-term use of non-steroidal anti-inflammatory drugs (NSAIDS) like aspirin or ibuprofen.

Peptic ulcer symptoms include:

• Burning stomach pain or discomfort in the upper belly or lower chest
• Pain that's often worse when your stomach is empty(between meals or at night)
• Pain that may be temporarily relieved by eating or taking antacids
• Bloating, belching, or feeling full quickly
• Nausea or vomiting
• In severe cases, vomiting blood, black or bloody stools, or severe abdominal pain

 Musculoskeletal Causes

The bones, muscles, cartilage, and other tissues that make up your chest wall can be sources of chest pain. Musculoskeletal chest pain is very common and, while often uncomfortable, is generally not dangerous.

        12. Costochondritis

Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. This cartilage can become inflamed due to injury, strain, arthritis, or infection, though a specific cause is often not identified.Costochondritis cause:

• sharp, aching, or pressure-like pain on the left side of the breastbone or in the rib cage
• Pain that affects multiple ribs, usually on the left side
• Pain that worsens with deep breathing, coughing, or physical activity
• Tenderness when you press on the affected area
• Pain that may improve with rest

     13. Rib Fracture

Rib fractures are breaks or cracks in the bones of your rib cage. They are usually caused by direct trauma to the chest, but can also occur from severe coughing or in people with weakened bones ( osteoporosis).Rib fractures cause:

• Sharp, severe pain at the fracture site
• Pain that worsens with breathing, coughing, laughing, or moving
• Tenderness when touching the affected area
• Shallow breathing ( because deep breathing hurts)
• Bruising or swelling over the fracture site

Anxiety and Psychological Causes

Your mental and emotional health can have very real physical effects, including chest pain. Anxiety-related chest pain is common and can be frightening, especially because it may feel similar to heart-related pain.

        14. Panic Attacks

A panic attack is a sudden episode of intense fear or anxiety that triggers severe physical reactions when there's no real danger or apparent cause. Panic attacks can occur unexpectedly or be triggered by specific situations. 

During a panic attack, you may experience:

• Chest pain or discomfort, often sharp or pressure-like
• Rapid, pounding heart rate
• Shortness of breath or feeling like you can't breathe
• Sweating, trembling, or shaking
• Feeling of choking
• Nausea or abdominal distress
• Dizziness, lightheadedness
• Numbness or tingling sensations
• Chills or hot flashes
• Fear of losing control (going crazy) or dying
• Feeling detached from reality

              15. Anxiety Disorder

Generalised anxiety disorder and other anxiety disorders involve persistent, excessive worry about various aspects of life. Unlike panic attacks, which are sudden and intense, anxiety disorders involve long-lasting anxiety that may be present most days. Chest pain and discomfort are common physical symptoms of long-lasting anxiety.

Anxiety-related chest pain:

• May be sharp, stabbing, or a dull ache
• Can be constant or come and go
• Often accompanied by muscle tension in the chest and shoulders
• May be associated with other anxiety symptoms, such as restlessness, fatigue, difficulty concentrating, irritability, and sleep problems 
• Often worsens during periods of stress or worry
• May be accompanied by rapid, shallow breathing

While the 15 conditions listed above are the most common causes, there are other possible causes of chest pain. 

How Do Doctors Diagnose the Cause of Chest Pain?

When you see a doctor for chest pain, they will identify the cause of the chest pain using several steps, including:

• Medical History and Physical Examination

Your doctor will ask about pain ( type, location, triggers) and checks vitals, heart, lungs, etc. 

• Electrocardiogram (ECG)

An ECG is a quick, painless test that records the electrical activity of your heart and can detect:

• Heart attacks (current and previous)
• Abnormal heart rhythms

• Blood tests

Several blood tests help diagnose the cause of chest pain, for example:

• Troponin for a heart attack. 
• D-dimer  for lung clots, etc  
• Complete blood count ( CBC) for infection and anaemia
• Metabolic panel for kidney function and electrolytes

• Chest X-Ray

A chest X-ray can reveal:

• Collapsed lung
• Heart failure  
• Rib fractures

• Echocardiogram

An echocardiogram sees the heart structure and function.

• Stress Test

Checks the heart's blood flow during exertion

• Computed Tomography (CT) Scan

CT Scan sees the heart and lung blood vessels and can detect blockages.

• Endoscopy

Checks the stomach and oesophagus

• Psychological Assessment

This is done if anxiety and/or depression are suspected. 

How Is Chest Pain Treated?

Treatment for chest pain depends on the underlying cause. Here are treatment approaches organised by urgency and type of condition:

Emergency Treatments

For life-threatening causes of chest pain, treatment begins immediately, often before a definitive diagnosis is made.

• Heart Attack

           Treatment for a heart attack includes the following:

• Prevent further clotting 
• Improve blood flow
• Oxygen therapy
• Pain relief
• Medications to dissolve clots. 

• Pulmonary Embolism

For pulmonary embolism, give:

• Blood thinners immediately
• Thrombolytics for large, life-threatening clots
• Oxygen therapy
• Clot removal or surgery in severe cases

• Aortic Dissection

Treatment includes:

• Blood pressure control
• Pain management
• Surgery to repair the aorta

• Pneumothorax (Collapsed Lung)

Treatment for pneumothorax involves:

• Remove air and re-expand the lung
• Oxygen therapy

Treatment of heart-related causes

• Angina

Angina treatment includes:

• Lifestyle modifications( diet, exercise, smoking cessation etc)
• Medications.  

• Pericarditis 

Treatment includes the following:

• Pain management 
• Rest and activity restriction
• Treatment of the underlying infection or cause

Treatment of lung-related causes

• Pneumonia

Treatment includes the following:

• Antibiotics for bacterial pneumonia
• Supportive care: rest, fluids, fever reducers
• Oxygen therapy, if needed

• Pleuritis

Pleuritis treatment includes:

• Pain management
• Rest and breathing exercises
• Treatment of the underlying cause

• Pulmonary Hypertension

Treatment involves:

• Reduce fluid buildup
• Medications 
• Oxygen therapy

Treatment of digestive system-related causes

• GERD 

Treatment involves the following:

• Lifestyle changes (dietary changes, weight loss, elevating the head of the bed, avoiding late meals)
• Antacids 

• Peptic Ulcer Disease (PUD)

PUD treatment involves:

• Antibiotics to eradicate H. Pylori
• Medications to reduce acid and promote healing
• Stopping NSAIDs if they caused the ulcer
• Lifestyle changes: avoiding alcohol, smoking cessation

Musculoskeletal Treatments

• Costochondritis and Rib Fractures

These can be treated as follows:

• Rest and activity modification
• NSAIDs for pain and inflammation
• Ice or heat application
• Physical therapy with stretching and strengthening exercises
• For rib fractures: adequate pain control to allow deep breathing and prevent pneumonia

Psychological Treatments

• Panic Attacks and Anxiety Disorders

Treatment includes:

• Cognitive behavioural therapy
• Medications
• Breathing exercises and relaxation techniques
• Lifestyle changes ( regular exercise, limiting caffeine and alcohol, stress management)

When Should You See a Doctor for Chest Pain?

While not all chest pain is an emergency, it's important to know when to seek medical attention. 

See a Doctor Soon( Within a day or two) if:

• You have new chest pain that you haven't experienced before
• Chest pain is mild but persistent or recurring
• You have chest pain with exertion that goes away with rest
• Chest pain is accompanied by heartburn symptoms that don't improve with over-the-counter antacids
• You have chest pain with a cough and fever
• You have chest pain that's reproducible by pressing on your chest wall, but you want to rule out other causes

What Chest Pain Symptoms Require Emergency Medical Attention?

Some chest pain symptoms are warning signs of life-threatening conditions that require immediate emergency care. Seek help immediately if you experience any of the following:

• Sudden, severe chest pain that feels like pressure, squeezing, fullness, or crushing
• Pain that lasts more than 15 to 20 minutes or goes away and comes back
• Pain that spreads to your shoulders, arms( especially the left arm), back, neck, jaw,or stomach
• Sudden, severe chest or back pain with a tearing or ripping sensation
• Chest pain accompanied by 
• Shortness of breath
•  Sweating
• Nausea or vomiting
• Dizziness or fainting
• Rapid or irregular heartbeat
• Extreme weakness or fatigue
• Confusion or difficulty speaking
• Weak or absent pulse in an arm or leg

Other emergencies include:

• Chest pain after chest trauma( car accident, fall, blow to the chest)
• Chest pain with sudden difficulty breathing, and you have risk factors for blood clots, such as recent surgery, long travel, cancer, pregnancy, birth control pills, etc

What to Do While Waiting for Emergency Services

• Stay calm and try to relax
• Sit or lie down in a comfortable position
• Loosen tight clothing around your neck and chest
• If you have aspirin and are not allergic, chew one, but only if you are sure you are not having a bleeding problem or aortic dissection
• If you have nitroglycerin prescribed for angina, take it as directed
• Do not eat or drink anything
• Have someone stay with you until help arrives
• Unlock your door so emergency responders can get in easily

Conclusion

Chest pain is a common symptom with many possible causes, ranging from life-threatening heart attacks to less serious conditions. While many causes are not dangerous, some conditions require immediate treatment to save your life or prevent serious complications. Don't play a guessing game; get it checked.

Seek help immediately if the pain is severe, spreads to the arm/jaw, or lasts more than 15 to 20 minutes. 

References

1. McConaghy JR, Sharma M, Patel H. Acute Chest Pain in Adults: Outpatient Evaluation. Am Fam Physician. 2020 Dec 15;102(12):721-727. Available from: https://www.aafp.org/afp/2020/1215/p721 
2. Bellicini MG, Shams P. Chest Pain: Evaluation and Exclusion of Myocardial Infarction and Angina. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. [Updated 2025 Dec 1]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557672/ PMID: 32491604. 
3. National Heart, Lung, and Blood Institute (NHLBI). Heart Inflammation - Pericarditis [Internet]. Bethesda (MD): National Heart, Lung, and Blood Institute; 2023 [cited 2026 Jun 22]. Available from: https://www.nhlbi.nih.gov/health/heart-inflammation/pericarditis. 
4. Levy D, Sharma S, Farci F, Le JK. Aortic Dissection. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. [Updated 2025 Dec 13]. [cited 2026 Jun 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441963/ PMID: 28722992.
5. Centers for Disease Control and Prevention (CDC). About Pneumonia [Internet]. Atlanta (GA): Centers for Disease Control and Prevention; 2026 [cited 2026 Jun 22]. Available from: https://www.cdc.gov/pneumonia/about/index.html.
6. Lim WS. Pneumonia—Overview. Encyclopedia of Respiratory Medicine. 2022:185-197. [cited 2026 Jun 22]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7241411/
   

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published June 26, 2022