- Chest pain that lasts more than 20 minutes or gets worse over time needs urgent medical evaluation.
- Chest pain with shortness of breath, dizziness, cold sweats, or nausea can be a warning sign of a heart attack.
- Pain that spreads to the arm, jaw, neck, or back should be treated as a medical emergency.
Chest pain is often not a sign of a heart attack and is commonly caused by gas, anxiety, muscle strain, or digestive problems. These causes can lead to discomfort or tightness in the chest that may come and go or worsen with certain movements or stress.
Even so, chest pain can sometimes be a symptom of a heart attack, especially in people with high blood pressure, high cholesterol, diabetes, or a history of smoking. In these cases, the pain usually becomes stronger over time and may spread to the arms, neck, or jaw, along with symptoms like shortness of breath, dizziness, or cold sweats.
Chest pain can also be related to conditions such as gastritis, acid reflux, respiratory infections, gallbladder problems, or inflammation of the chest wall. Medical care is recommended when chest pain lasts more than 20 minutes, worsens, or appears with symptoms like difficulty breathing, nausea, or intense discomfort.
Why does my chest hurt?
The main causes of chest pain are:
1. Gas pain
Excess gas is one of the most common causes of sharp left-sided chest pain, especially in people with chronic constipation. This happens because gas buildup in the intestines can create pressure in the abdomen, causing pain that may spread to the chest.
How to identify: This pain is usually intermittent, very sharp, and tends to come and go. It may happen repeatedly and can be triggered by movements such as bending down to pick something up from the floor.
What to do: One way to relieve this type of pain is to gently massage the abdomen, moving from the right side to the left and then downward toward the groin.
Lying on your back with your knees pulled up to your chest and walking for a few minutes may also help release trapped gas. Check out additional tips for how to get rid of gas.
2. Stress and anxiety
Anxiety and stress can cause the muscles around the ribs to tighten and the heart rate to increase, which may lead to a feeling of chest tightness. This type of discomfort can happen during periods of emotional stress, after an argument, or in people with panic attacks or anxiety disorders.
How to identify: Chest tightness related to anxiety usually happens along with symptoms such as rapid breathing, sweating, a fast heartbeat, nausea, and bowel changes.
What to do: Resting in a quiet place, drinking a calming tea such as chamomile or valerian, or doing a relaxing activity may help relieve symptoms.
However, urgent medical care is needed if the chest tightness does not improve within 30 to 60 minutes, gets worse, or happens with symptoms such as shortness of breath, dizziness, sweating, nausea, or pain that spreads to the arm, jaw, or back.
Learn more about how to identify a panic attack vs a heart attack.
3. Heart attack
Heart attack is often the first concern when chest pain happens, but it is not the most common cause. Still, the risk is higher in people over 45 and in those with uncontrolled high blood pressure, high cholesterol, diabetes, or a history of smoking.
How to identify: According to the American Heart Association, chest pain related to a heart attack is often intense, may last more than a few minutes or come and go, and can spread to the arms, neck, or jaw, sometimes occurring with shortness of breath, dizziness, or cold sweats. It may also be accompanied by tingling in the arms or legs and a general feeling of being unwell.
What to do: If a heart attack is suspected, emergency medical care is needed right away. Call 911 or have someone take you to the nearest hospital right away. Evaluation at the hospital usually includes tests such as an ECG, blood tests, and a chest X-ray.
4. Gastritis
Gastritis can also cause chest pain, which is usually in the center of the chest, and may spread to the back.
It is more common in people with poor eating habits, but it can also happen with ongoing stress or anxiety, which may cause stomach irritation and inflammation.
How to identify: Gastritis symptoms may include a feeling of fullness, loss of appetite, heartburn, and excessive burping.
What to do: Symptoms may improve by reducing stomach irritation. One simple option is drinking water with a few drops of lemon. Learn more about other gastritis treatments your doctor may prescribe, plus additional home remedies.
5. Sore muscles
Sore chest muscles are common after exercise, a hard workout, intense coughing, or lifting something heavy. Stress and anxiety can also cause the chest muscles to tighten, which may lead to soreness and inflammation.
How to identify: This type of chest pain usually gets worse when taking a deep breath or with certain movements, such as twisting your upper body or reaching behind you.
What to do: Resting and applying a warm compress to the area can help relieve sore muscles. Gentle chest stretches may also help, such as placing the arms behind the back and holding the hands together.
6. Acid reflux (GERD)
People with acid reflux (GERD), especially those who do not follow a reflux-friendly GERD diet, may have frequent chest pain. This pain usually happens when stomach acid flows back into the esophagus and irritates its lining.
How to identify: In most cases, this chest pain starts in the middle of the chest. It is often accompanied by a burning sensation, stomach pain, or mild tightness in the upper chest or throat.
What to do: Chamomile or ginger tea may help support digestion and reduce stomach acidity, which can ease irritation in the esophagus. Antacids or other GERD medications may also help, and between episodes, a light diet that avoids fatty or spicy foods is usually recommended.
Read more about acid reflux home remedies to help relieve symptoms of reflux naturally.
7. Stomach ulcers
Chest pain caused by a stomach ulcer happens because the lining of the stomach becomes inflamed. Since the stomach is close to the chest, this pain can sometimes be mistaken for heart-related pain.
How to identify: This type of chest pain is usually felt in the center of the chest, but it can spread to the right side depending on where the ulcer is located. It is more likely to happen after eating and may occur with bloating, nausea, or vomiting.
What to do: If a stomach ulcer is suspected, a primary care provider or gastroenterologist should be consulted for evaluation. If the diagnosis is confirmed, treatment may include medications such as omeprazole and dietary changes.
While waiting for medical assessment, potato juice may help relieve symptoms by reducing stomach irritation.
8. Gallbladder problems
The gallbladder is a small organ located on the right side of the abdomen, just below the liver. It can become inflamed due to gallstones or after eating too much fatty food, which may cause right-sided chest pain that can sometimes be mistaken for heart-related pain.
How to identify: This pain usually affects the right side of the chest or upper abdomen and often gets worse after eating, especially after fried or fatty foods. Other symptoms such as nausea, bloating, or discomfort after meals may also occur.
What to do: It is important to avoid fatty foods and drink plenty of water. If the pain does not improve, gets worse over time, or is very intense, medical care is recommended.
9. Respiratory problems
Respiratory problems, such as bronchitis, asthma, or lung infections, can also cause chest pain. Because the lungs are located inside the chest and close to the heart, pain from a breathing-related condition can sometimes feel similar to heart pain.
How to identify: This type of chest pain may happen when coughing or breathing, especially during a deep breath. Other symptoms, such as shortness of breath, wheezing, or a persistent cough, may also be present.
What to do: Medical evaluation is recommended if a respiratory cause is suspected. A doctor can identify the underlying problem and recommend the most appropriate treatment.
10. Heart conditions
Various heart conditions, such as angina and arrhythmias, can cause chest pain. Heart-related chest pain is often accompanied by symptoms like fatigue, shortness of breath, palpitations, or swelling.
How to identify it: Chest pain caused by a heart problem may feel like tightness or pressure in the chest and may occur along with palpitations, swelling, fatigue, or shallow breathing.
What to do: A doctor should evaluate this type of chest pain to check how the heart is functioning. Tests may be ordered, and if a heart condition is diagnosed, treatment can help relieve the chest pain.
11. Costochondritis
In some cases, chest pain can be caused by costochondritis, which is inflammation of the cartilage that connects the ribs to the sternum, the bone in the center of the chest. This pain is often worse when pressure is applied to the chest or when lying face down.
How to identify: Costochondritis usually causes soreness in the chest and pain that gets worse when pressing on the area, coughing, or breathing deeply.
What to do: A warm compress may help relieve sternum pain. A doctor may also recommend anti-inflammatory medication if needed.
When to go to the hospital
Medical attention is recommended if chest pain lasts longer than 20 minutes or gets worse over time. It is also important to seek care if chest pain occurs with symptoms such as:
- Dizziness
- Cold sweats
- Nausea or vomiting
- Difficulty breathing
- Severe headache
According to the CDC, possible symptoms of a heart attack include chest pain or discomfort, shortness of breath, dizziness, nausea or vomiting, and pain that may extend to the upper body, which is why urgent medical evaluation is recommended when these symptoms happen together.