Chest pain: possible causes

By Cristiano Antonino On Feb 15, 2023

Chest pain is a symptom that immediately raises alarm bells. Feeling a strong pain in the chest immediately leads one to think of a heart attack, one of the most common causes of this type of pain, but this is not always the case

There are several causes of chest pain, and in fact it is a very common complaint that only in some cases is an alarm bell for a heart condition.

If you experience chest pain, you should not be alarmed, but you should still contact your doctor in order to establish what the causes are and take appropriate action.

Let’s find out what the main causes are and the most common symptoms.

Chest pain, the symptoms

Chest pain refers to a sharp pain or discomfort in the chest, between the neck and abdomen.

The pain often radiates into the chest from the neck and may involve the back and left arm.

Although it is not always a heart attack, one should never overlook this symptomatology and the best thing to do is always to seek medical advice.

In particular, you should be alert if the person displaying the symptoms is a heart patient or suffers from a particular ailment, if he or she is elderly, a child or a pregnant woman.

Causes of chest pain

The causes of chest pain are many, they can be cardiac causes, digestive causes (among the most common), musculoskeletal causes, pulmonary causes, panic attacks.

The first thing it is important to rule out, however, is that it is not a heart attack.

The symptoms of a heart attack, unfortunately, vary from patient to patient, so it is not always easy to recognise it at the first visit.

Clearly, those who have already had a heart attack or are considered at risk will have to pay much more attention to the symptoms of pain.

Recognising a heart attack

The pain caused by a heart attack is not always acute and recognisable; sometimes a heart attack occurs without any painful symptoms, particularly in diabetics, women or the elderly.

One can then detect severe discomfort, but without pain or, on the contrary, severe and sharp pain, shortness of breath, nausea, pain in the back, jaw and shoulder, and pain in the left arm.

Usually the pain starts in the upper part of the body, the breath becomes short, cold sweat also occurs as a symptom, in women severe tiredness.

If you recognise yourself in these symptoms you should quickly contact your doctor or call a cardiologist at home.

Other causes of chest pain

As far as cardiac disorders are concerned, in addition to heart attack, we must pay attention to other problems:

Angina: this manifests itself as a sharp, oppressive, twinge-like pain during exertion, caused by cardiac ischaemia.
Pericarditis: this also presents as a sharp pain but during inspiration, very similar to the pain of a heart attack, but the cause is an inflammation of the membrane that covers the heart, the pericardium.
Aortic dissection: manifested by a stabbing pain in the chest due to the separation of the inner layers of the blood vessel of the aorta, our main artery. The pain is mostly felt in the chest, between the shoulder blades and is sharp and sharp, and can be life-threatening.

Very common are digestive causes that cause severe chest pain:

Hiatal hernia, gastritis, reflux: all these disorders, which are not serious but still need to be kept under control, can cause chest pain that can often be confused with a heart attack. The difference is that in these conditions there is also a burning sensation behind the sternum.
Other ailments that cause chest pain always related to the digestive system are swallowing disorders, i.e. problems with the oesophagus, but also gallstones, inflammation of the pancreas and gallbladder, which first cause abdominal pain that then radiates into the chest.

Lung causes, on the other hand, include the following:

Pleuritis: due to inflammation of the pleura, the membrane that lines the lungs. The pain this disorder causes is dull and deep and intensifies during coughing attacks and during breathing.
Pulmonary embolism: Here too, we are faced with oppressive chest pain due to a blood clot, the embolus, which interposes itself on the venous flow in the main arteries to the point of completely obstructing it, causing a pulmonary infarction. In this case, 118 should be called immediately.
Other causes of chest pain due to pulmonary disorders are pulmonary hypertension and lung collapse.

As far as musculoskeletal causes are concerned, muscular pain that causes persistent chest pain, rib fractures and costochondritis, an inflammation of the cartilage that holds the ribs together at the sternum, should be considered.

Panic attacks can also result in severe chest pain very similar to a heart attack, also because there is a rapid heartbeat, rapid breathing, heavy sweating, dyspnoea and dizziness associated with a strong fear of dying.

Similar symptoms are seen in patients suffering from herpes zoster, or shingles.

What to do if you have chest pain

If you experience the symptoms described above, you should contact a doctor immediately.

You can go to your general practitioner when the pain is not in an acute phase, i.e. at the first signs, or call a doctor at home.

But if you are in doubt about the nature of the pain or have a history of heart disease, calling the Emergency Number is absolutely the best choice.

It is essential to pay attention to the symptomatology and describe it accurately to the doctor so that he or she can take a correct anamnesis to be combined with an instrumental evaluation in order to obtain the right diagnosis.

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