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How to know if chest pains are serious

Chest pain can stem from many health issues. Some are quite serious, while others may be nothing to worry about.

Sometimes, chest pain indicates a blocked artery and a heart attack. This is an emergency situation, in which the heart is not receiving enough blood and oxygen to function correctly.

However, chest pain can also stem from a health issue affecting the lungs, stomach, or muscles, for example.

It is crucial to receive emergency care for chest pain, especially if it is sudden and severe and accompanied by shortness of breath, dizziness, or both.

Many heart conditions can cause chest pain, including:

Heart attack

A heart attack may be the best-known cause of chest pain, and the pain usually occurs in the center of the chest.

People experience this pain differently — some describe it as uncomfortable, sharp, sudden, and severe, while others report a squeezing sensation. In some people, the pain comes and goes.

It is worth noting that a heart attack does not always cause chest pain. A person may experience other symptoms, with or without chest pain, including:

  • cold sweats
  • lightheadedness
  • nausea
  • pain in other areas, such as the arms, back, jaw, or stomach
  • shortness of breath
  • dizziness
  • sweating

Also, males and females may experience heart attacks differently. Learn about the symptoms common in females here.

Anyone who believes that they may be having a heart attack should receive immediate medical attention.

Aortic dissection

This cause of chest pain is a life threatening condition in which a tear forms in the lining of the aorta, one of the body’s most important arteries.

If the tear is large enough or a doctor cannot treat it in time, it can cause fatal bleeding.

The symptoms are similar to those of a heart attack, and they may also include:

  • leg pain or paralysis
  • paralysis on one side of the body
  • difficulty speaking or seeing

Anyone who may be experiencing this should receive immediate medical care.

Pericarditis

Pericarditis occurs when the sac that surrounds the heart, called the pericardium, becomes inflamed.

This can cause chest pain, especially when a person takes a deep breath.

Aortic stenosis

The aortic valve allows oxygenated blood to flow out of the heart’s left ventricle and into the rest of the body.

Stenosis occurs when this valve becomes stiff, either from age or disease. When this happens, and the heart pumps out less blood, it can cause chest pain.

Hypertrophic cardiomyopathy

This condition causes the heart’s muscle to become overly thick, shrinking the heart’s chambers. As a result, the heart is able to hold less blood and cannot pump as effectively.

Hypertrophic cardiomyopathy can also prevent the heart from keeping a healthy electrical rhythm.

The lungs reside in the chest cavity, and the following health issues affecting the lungs can cause pain in the area:

COPD

Chronic obstructive pulmonary disease (COPD) is an umbrella term for emphysema and chronic bronchitis.

People with COPD often have pain in the upper middle chest, as well as lung inflammation, frequent coughing, and airway swelling.

They may also experience costochondritis — inflammation of the muscles between the ribs. This can cause discomfort and stabbing, burning, or aching chest pain.

People without COPD can also develop costochondritis, triggered by a viral illness, for example.

Lung infections

Upper or lower respiratory infections, as well as pneumonia, can lead to chest pain.

This is especially likely if a person is frequently coughing, which can tire and irritate the chest muscles.

Pulmonary embolism

This refers to a clot that blocks the flow of blood in the lungs. It is a medical emergency that can be life threatening.

Symptoms of a pulmonary embolism include shortness of breath, anxiety, dizziness, and coughing.

The following health issues affecting the stomach or esophagus — a thin tube that connects the mouth to the stomach — can lead to chest pain:

Esophageal spasm

This refers to the esophagus contracting and relaxing rapidly. The result can be severe chest pain and discomfort, among other symptoms.

The causes of these spasms are unclear, but stress and dietary and environmental factors may play a role.

Learn more about esophageal spasms, including who is at risk, here.

GERD

Gastroesophageal reflux disease, or GERD, is a chronic condition that causes stomach acid to rise into the esophagus and mouth.

This can cause a burning sensation in the chest so severe that it resembles the pain of a heart attack.

Nutcracker esophagus

This condition, also called jackhammer esophagus, can cause esophageal spasms and food to rise back up into the esophagus, an issue called achalasia.

Other health issues that affect the esophagus can also lead to chest pain. These include ulcers and inflammation, such as the inflammatory condition eosinophilic esophagitis.

Chest pain sometimes stems from a pulled chest muscle or inflammation of these muscles, and the symptoms can be so severe that they resemble those of a heart attack.

A person might experience:

  • numbness
  • sharp, shooting pain that extends to the back and neck
  • tingling

Also, a broken or sprained rib can also lead to chest pain. Learn more about the symptoms of a broken rib here.

Sometimes, extreme anxiety and other mental health issues cause chest pain.

A person may, for example, be experiencing a panic attack, which can also cause:

  • the heart to pound loudly
  • heart palpitations
  • a rapid heart rate
  • shaking
  • shortness of breath
  • sweating
  • lightheadedness or dizziness
  • nausea

Another cause of chest pain that relates to the emotions is takotsubo cardiomyopathy. This occurs when an extremely stressful experience causes temporary changes in the heart.

Doctors also call this condition “broken heart syndrome,” and the symptoms can mimic those of a heart attack.

A person should receive immediate medical attention for chest pain, even if the cause does not turn out to be a heart condition.

It is especially important to receive urgent care if any of the following accompany chest pain:

  • confusion
  • dizziness
  • nausea
  • shortness of breath
  • weakness
  • numbness

If a person recognizes the cause of their chest pain, such as acid reflux or COPD, they should contact their doctor if the symptoms worsen.

In a 2019 analysis of approximately 61,000 ambulance calls, an estimated 16.4% related to chest pain.

There are many potential causes of this pain, but it is a symptom that warrants immediate attention. Anyone who may be having a heart attack should receive emergency care as quickly as possible.

Tests, scans, and a careful assessment of symptoms can help a doctor identify the issue and recommend the right course of treatment.

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