By Korin Miller – Self
Chest pain can make it feel like your body has pressed a panic button, especially when it seemingly strikes out of nowhere. Here’s the good news: Chest pain can actually happen due to a slew of causes, including quite a few that aren’t too hard to treat. (Translation: Don’t just resign yourself to having a heart attack, because that’s absolutely not the only possibility here.)
It’s pretty normal to have some chest pain at some point in your life, Susan Besser, M.D., a primary care physician at Mercy Medical Center in Baltimore, tells SELF. After all, your body has a lot going on in that region. That doesn’t mean chest pain is something to ignore, though. You should always get it checked out, Kimbra Bell Balark, M.D., assistant professor of clinical medicine at Northwestern University Medical School, tells SELF. Even if you feel like you’re in great health, there are so many important organs in and around your chest that it’s always worth seeing a doctor about pain in that area, she explains.
To ensure you’re walking into your doctor’s appointment with as much information as possible, here are some of the biggest reasons random pain might bubble up in your chest.
- Acid reflux or gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) happens when your stomach acid frequently flows back up into your esophagus, the tube that connects your mouth and stomach, according to Mayo Clinic. This backwash is called acid reflux or even simply just reflux. You get into GERD territory when you experience mild acid reflux at least twice a week, or a moderate to severe form at least once a week, the Mayo Clinic says.
Acid reflux can irritate the heck out of your esophageal lining. If you have it, say hello to a terrible burning sensation, aka heartburn, and chest pain, along with symptoms like difficulty swallowing, feeling like there’s a lump in your throat, and even possibly regurgitating some food or sour liquid.
GERD is actually the most common cause of non-cardiac chest pain, causing up to 66 percent of chest pain that isn’t related to heart issues, according to the Cleveland Clinic. If you think you have it, definitely mention the burning in addition to chest pain when you see your doctor. That will help them determine the kinds of diagnostic tests you might need, like an upper endoscopy, which uses a thin tube to see down your throat into the inside of your esophagus and stomach. From there, they can recommend treatment options to get rid of the burning and chest pain and help your inflamed esophagus heal.
- Cyclic or non-cyclic breast pain
Sometimes it’s hard to tell breast pain from chest pain. For instance, there’s cyclic breast pain, which is linked to your menstrual cycle. Some people develop tender breasts right before their periods thanks to hormonal changes, Jessica Shepherd, M.D., an ob/gyn at Baylor University Medical Center at Dallas, tells SELF. This can be most uncomfortable leading up to your period, and the feeling can range from an ache to actual WTF-level pain. A non steroidal anti-inflammatory drug like Motrin should help, Dr. Shepherd says, but if you notice that you’re having severe pain at this time every month, you should talk to your doctor.
Non-cyclic breast pain isn’t associated with your period, and it can happen due to things like a hardcore workout that taxes your pectoral muscles. Similarly, taking an NSAID can help with this kind of pain—but if the soreness is unexpectedly intense or you’re experiencing sharp pain that might signal an injury instead, check in with your doctor.
People might think asthma is just about breathing troubles, but this respiratory condition can cause chest pain, too. Asthma affects the airways that go from your nose and mouth to your lungs. When people with asthma are exposed to triggers, like dust, cold air, pollen, and mold, their airways might narrow, making it hard for them to breathe, according to the National Heart, Lungs, and Blood Institute (NHLBI). Asthma triggers can also make the muscles surrounding your airways constrict and inflame your airways, causing them to produce more mucus.
With all that in mind, it’s no wonder that chest pain or tightness are common asthma symptoms, according to the Mayo Clinic. Some people with asthma even say that their lungs feel achy, Dr. Besser says. Beyond that and trouble breathing, asthma can also cause wheezing (a whistling sound when you breathe) and coughing.
If you’re grappling with chest pain and other disruptive symptoms like a persistent cough and wheezing, talk to your primary care physician about the possibility that you might have asthma. They can do some tests to measure your lung and airway function, then move on to treatment that can help you breathe as well as possible.
- A panic attack
Everyone experiences panic attacks differently, but they often come with feelings of impending doom, shortness of breath, heart palpitations, and chest pain. “This is a common reason why people go to the ER and say that they feel like they’re having a heart attack,” Dr. Balark says.
If you’re worried you might be having a heart attack—whether or not you think the sensation is stemming from a panic attack—get yourself to an emergency room immediately. It’s hard for the average person to know the difference between a panic attack and an actual heart attack, Dr. Besser says, but a medical professional can figure out which you’re dealing with and do their best to help you either way.
Pneumonia is an infection that inflames the air sacs in your lungs, which are just trying to help you breathe to your best ability. The sacs can fill with fluid or pus, causing a cough, fever, chills, and difficulty breathing, the Mayo Clinic says.
Unfortunately, pneumonia can also cause sharp, stabbing chest pain that gets worse when you breathe deeply or cough, according to the American Lung Association. Talk about a vicious cycle.
If you do indeed have pneumonia, it’s unlikely that chest pain would be your only symptom, Dr. Balark says. You’d typically be dealing with some of the other signs mentioned above that more clearly point to an upper respiratory infection. Either way, if you suspect that you have this issue, see your doctor ASAP for diagnosis and medication to kick the infection. Pneumonia can be serious and even fatal if it goes untreated.
- A collapsed lung
This happens when air gets into your pleural space (the area between your lung and your chest wall), according to the U.S. National Library of Medicine. That air then pushes on the outside of your lung and actually makes it collapse, the Mayo Clinic says.
Most of the time, only a portion of the lung collapses, which may not cause any symptoms. It’s also possible for a larger portion or the whole lung to cave in, in which case your body will likely sound the alarm with sudden chest pain and shortness of breath. The pain comes from tension on your nerves in and around your lung and the pressure of the “escaped” air from your collapsed lung on your chest wall, Dr. Besser says.
Collapsed lungs don’t typically just happen—there are a few risk factors to keep in mind, like a chest injury or damaged lung tissue from a condition like pneumonia and chronic obstructive pulmonary disease (commonly known as COPD, this is a group of lung diseases like chronic bronchitis and emphysema), according to the Mayo Clinic.
If your doctor suspects you have a collapsed lung, they’ll give you a chest X-ray or CT scan to see what’s going on in there, the Mayo Clinic says. Depending on the severity of your collapsed lung, they’ll devise a treatment plan with the goal of relieving that painful pressure.
Angina isn’t a disease—it’s a feeling. This chest pain or discomfort, which is often a sign of heart disease, happens when your heart muscle doesn’t get enough oxygen-rich blood, according to the American Heart Association. It can feel like pressure or squeezing in your chest, or general discomfort in your shoulders, arms, neck, jaw, or back.
There are two kinds of angina: Stable and unstable, the Mayo Clinic says. Stable angina happens when you exert yourself physically, usually feels similar to chest pain you’ve had in the past, most likely lasts five minutes or less, and disappears if you rest or take angina medication. Unstable angina can be unexpected and happen even when you rest, last 30 minutes or longer, may feel more severe than chest pain you’ve experienced before, and can signal a heart attack.
If you think you have either form of angina, you need to see a doctor to get evaluated. Usually that involves an electrocardiogram (a recording of electrical signals as they travel through your heart), a stress test (a measure of your blood pressure or electrocardiogram as you exercise), an echocardiogram (which uses sound waves to produce images of your heart), or a chest X-ray, the Mayo Clinic says. But if you suspect you’re specifically having unstable angina, you need to get to an ER immediately in case it’s due to a heart attack. Before you decide your chest pain is definitely angina, keep this in mind: If you’re young and otherwise healthy, it’s probably not. “Most healthy young people who experience chest pain are more likely to have benign causes,” Jennifer Haythe, M.D., assistant professor of medicine and co-director of the Women’s Center for Cardiovascular Health at Columbia University Medical Center, tells SELF.
- A pulmonary embolism
You’ve probably heard that pulmonary embolisms are scary, but you may not know exactly what they are. A pulmonary embolism happens because of a blockage in a pulmonary artery in your lung, and it typically occurs when a blood clot travels to the area from one of your legs, according to the Mayo Clinic.
Pulmonary embolisms usually cause symptoms like shortness of breath, a cough, and chest pain. The chest pain can make you think you’re having a heart attack, and it may get worse when you take a deep breath, cough, bend, or stoop over, the Mayo Clinic says. It will also usually get worse when you exert yourself, but confusingly won’t go away when you rest.
Other signs that you might be dealing with a pulmonary embolism can include leg pain or swelling, fever, excessive sweating, a rapid heartbeat, and dizziness. Basically, your body will likely let you know you’re having an emergency, which does basically sum up a pulmonary embolism. This kind of blockage can impede blood flow to your lungs, meaning it can be life-threatening. This sounds really scary, and it is. But as the Mayo Clinic notes, prompt treatment really boosts the chances of surviving a pulmonary embolism.
If you suspect you have a pulmonary embolism, get to the ER immediately. There, doctors will likely give you a chest X-ray or CT scan to diagnose it, then figure out the best way to dissolve or remove the clot.
- A heart attack
This one is last on the list because there are so many other less worrisome things that could be your chest-pain culprit. With that said, yes, sometimes chest pain actually is a sign of a heart attack, so it’s worth reading up, just in case.
Chest pain or discomfort is the most common symptom of heart attacks, the American Heart Association says. “A heart attack causes chest pain because a blockage in one or more coronary arteries prevents blood flow to the heart,” Dr. Haythe says. “When the heart is deprived of oxygen, which it needs to pump, patients feel pain.” The pain can be anything from a heavy dull ache across your chest to a sharp pain that radiates down your left arm and neck, Dr. Haythe says.
With that said, women are more likely than men to experience stealthier heart-attack symptoms like shortness of breath, nausea or vomiting, and back or jaw pain, so it’s smart to be aware of those as well.
Since a heart attack is a life-threatening emergency, if you think you’re having one, seek emergency medical treatment immediately.
Again, if you’re an otherwise healthy person, it’s pretty likely that your chest pain is due to something less severe than a heart attack, like GERD. But, as Dr. Balark points out, you really never know, so you might as well get it checked out. Chest pain isn’t something you should have to live with, regardless of the cause.