12 things in your home that Lead to Heart Disease
Searching for products?

What Causes Chest Pain? (hint: It’s not always a heart attack)

  This post may contain affiliate links
Facebook
Twitter
Reddit
WhatsApp
Email
woman experiencing chest pain

Chest pain isn’t always a sign of a heart attack. Read on to discover what else could be causing your chest to ache.

What comes to mind when you hear the phrase “chest pain?” Most people’s brains immediately focus on the worst-case scenario and associate chest pain with a heart attack. And, in some cases, they may be right. Chest pain is something that should never be ignored. 

Non-traumatic chest pain is the second leading cause of emergency room visits in the United States, bringing close to 7 million people through the hospital doors each year. However, most people with chest pain are not having an acute heart attack. In fact, a recent study found that less than only 5.5 percent of people arriving at the emergency room with chest pain had an immediate life-threatening heart issue. 

While it may bring relief to know that most chest pain is not a heart attack, it still may signal a life-threatening problem. Pain, no matter the location, is a warning sign that something has gone awry. It’s our body’s way of sending an SOS. And, if neglected, it may lead to catastrophic results.

man experiencing cardiac event

The heart is located in the front of the chest, sitting slightly left of the breastbone. This strong muscle pumps blood throughout the body through thousands of vessels. Just as all body parts require oxygenated blood, so does the heart. 

Cardiac-related chest pain presents differently in each individual. However, it often results in left-sided chest pain. There are several reasons the cardiovascular system can cause chest discomfort, including:

Heart attack

A heart attack, also known as a myocardial infarction (MI), happens when the flow of blood that brings oxygen to the heart is blocked. Without enough blood, the heart muscle begins to spasm and cause pain. 

Typical characteristics of heart attack pain include: 

  • May be sudden and intense or may come on more slowly
  • Uncomfortable pressure, squeezing, fullness, burning, or tightness in chest
  • Usually lasts more than a few minutes or may go away and come back again
  • May present in other parts of your body, such as your arms, back, neck, jaw, and stomach
  • Occurs at rest or when active 

Coronary artery disease

Coronary artery disease (CAD) is caused by damaged blood vessels that supply the heart with oxygen. In CAD, plaque deposits gather along the artery walls, narrowing the blood’s pathway to get to the heart. Deprived of oxygen, the heart cries out with chest pain, also called angina. 

Typical characteristics of CAD (angina) pain include:

  • May be mild or severe
  • Heaviness, tightness, aching, pressure, burning, fullness, squeezing, dull ache in chest 
  • Discomfort may also present in the shoulder, arm, neck, back, or jaw
  • Chest pain typically limited to physical activity or when under stress

Myocarditis, pericarditis, or endocarditis 

As the names suggest, myocarditis, pericarditis, and endocarditis all indicate inflammation around the heart. Pericarditis involves inflammation in the sac that surrounds the heart. Myocarditis is inflammation of the heart muscle itself. Endocarditis impacts the inner layer of the heart. Inflammation of the heart often reduces its ability to pump effectively and can lead to irregular heart rhythms. 

Typical characteristics of inflammatory heart pain include:

  • Tightness or squeezing in the middle or left side of the chest
  • Often felt behind the breastbone or collarbone
  • Present with rest and with exertion
  • Chest pain is usually made worse by movement such as coughing, breathing, or swallowing
  • Chest pain is sometimes relieved when leaning forward and typically worsens with lying flat
  • Pain may spread to the neck, back, and shoulders

Aortic aneurysm or dissection 

An aortic aneurysm is an enlargement or ballooning of a section of the aorta, the major artery that carries blood out of the heart. An aortic dissection occurs as a result of a tear in the wall of the aorta. This life-threatening condition must be diagnosed and treated promptly. 

Typical characteristics of aortic pain include:

  • Sudden severe and sharp pain in the chest and upper back
  • Often produces a tearing or ripping sensation
  • Pain may move from one location to another 

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy occurs when the heart muscle thickens, making it difficult to pump effectively. 

Typical characteristics of cardiomyopathy pain include:

  • Chest pain that typically presents after exertion or with heavy meals

Non-cardiac causes of chest pain 

Not all chest pain is related to the heart. In fact, there are several reasons why someone might experience chest pain, including: 

Lung-related causes 

woman having difficulty breathing

The lungs sit in the chest. As a result, pulmonary discomfort is often confused with cardiac pain. Acute infections such as pneumonia or Covid-19 can cause chest pain. Other lung issues that can produce chest pain include: 

  • Pulmonary embolism – A pulmonary embolism (PE), or blood clot, occurs due to a blockage in the artery of the lungs. Chest pain is typically one-sided or may present under the breastbone. It is often described as a sharp pain that worsens during inhalation.
  • Pleurisy – Pleurisy is inflammation of the thin layers covering the lungs and chest cavity. If left untreated, it can evolve into a pleural effusion, a build-up of fluid in the cavity surrounding the lungs. Pleuritic pain typically presents as a sharp, stabbing pain that worsens with breathing, sneezing, coughing, or moving. Pressure on the area sometimes relieves the pain. Pain with pleurisy sometimes radiates to the shoulders and back.
  • Pneumothorax – A pneumothorax is a medical term used to describe a collapsed lung. Pain from this condition typically is sharp and worsens with breathing or deep inhalation. Similar to pleurisy, pain with a pneumothorax often radiates to the shoulder and back.
  • Pulmonary hypertension – Pulmonary hypertension (PH), or high blood pressure in the lungs’ arteries, is an underdiagnosed cause of chest pain. Chest pain with PH often presents in the front of the chest. 

Digestive causes 

man with digestive upset

Many digestive organs sit close to the chest cavity. For example, the gallbladder sits to the right of the chest, the pancreas to the left, and the stomach slightly to the right of the center. Therefore, pain originating from these areas can feel like chest pain. 

  • GERD/Indigestion – Gastroesophageal reflux disease (GERD), also referred to as acid reflux,  heartburn, or indigestion, is a common disorder that can mimic the symptoms of a heart attack. In fact, GERD is the most common cause of non-cardiac chest pain.

With GERD, highly-acidic stomach acid flows back into the esophagus, causing a burning sensation in the chest. GERD can also cause a squeezing feeling behind the breastbone that comes and goes, much like a heart attack. GERD pain sometimes radiates to the back and shoulder as well. 

  • Gallbladder disease – The most common symptom for those with gallbladder disease is right-sided abdominal or chest pain. Gallbladder pain often radiates to the right shoulder or between the shoulder blades in the back. Gallbladder attacks often happen after meals or at night and can come and go. 
  • Esophageal conditions – The tube that connects our mouths to our stomachs is the esophagus. The esophagus runs down the center of the chest, and many disorders of the esophagus can contribute to chest pain. 

Musculoskeletal causes 

man with rib out of place

Several bones and muscles surround our chest cavity and can contribute to pain. Many wonder how to tell the difference between muscular pain and heart-related discomfort. In most cases, muscular pain worsens with movement and improves with rest. Musculoskeletal chest pain can be caused by the following: 

  • Costochondritis – Costochondritis is a condition in which the cartilage that holds the ribs to the breastbone becomes inflamed. Costochondritis often affects the upper ribs on the left-hand side of the chest, where the ribs attach to the breastbone. Pain associated with costochondritis mimics heart-associated discomfort in that it’s sharp and may radiate to the back. However, pain with costochondritis increases with a deep breath or cough. 
  • Muscle strains or spasms – Muscle strains are a common cause of chest pain and may result from weight lifting, coughing, poor posture, or blows to the chest. Muscle strains in the chest may cause sharp or dull pain that typically worsens with movement. 

Psychological causes 

older man having anxiety and chest pain
  • Anxiety or panic attacks – One of the most frightening symptoms of anxiety is chest pain. Chest pain occurs with anxiety for various reasons, including a sudden release of stress hormones that cause the blood pressure and heart rate to rise. Chest pain characteristics vary for those with anxiety but may be dull, sharp, stabbing, burning, or aching. 
  • Takotsubo (stress) cardiomyopathy – Stress cardiomyopathy, or Broken Heart Syndrome, is caused by sudden acute stress. A traumatic event such as the death of a loved one can cause a weakening of the heart muscle and symptoms that mimic a heart attack. 

When should I worry about chest pain? 

New onset chest pain should always be evaluated to rule out an immediate cardiac problem. However, the following chart may help guide decision-making when evaluating the seriousness of your chest discomfort. 

Next Steps

While no one wishes to experience pain, it’s truly a gift. Pain is a valuable signal in our bodies, alerting us that something is off-balance or needs attention. While chest pain may not always indicate a deadly heart attack, it is most certainly a cry for help. 

If you or a loved one experiences acute chest pain, seek emergency care without delay. Once the doctor has cleared you, you will want to investigate the cause of your pain. Consider working with one of our expert health providers to help uncover the root cause of your chest discomfort once and for all. 

Eat well, Live well, Think well

Medical Review: Dr. Lauren Lattanza 2022

Facebook
Twitter
Reddit
WhatsApp
Email

You may also enjoy these posts...

About Dr. Keith Smigiel NP, DC

Dr. Keith Smigiel

Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.

Chiropractic

Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

Call (480) 535-6844 for details and scheduling.

Acupuncture

Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

Call (480) 535-6844 for details and scheduling.

Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

Call (480) 535-6844 for details and scheduling.

Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

Call (480) 535-6844 for details and scheduling.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.