Heart Pain: 8 Causes & When to Go to the Hospital

Updated in March 2022

Although heart pain is commonly associated with a heart attack, this type of pain is actually not often not caused by a heart attack. Common causes of heart pain include excess gas, anxiety and costochondritis.

Nonetheless, if you experience heart pain, you should seek assessment to rule out any serious conditions. A heart attack usually causes a tightening, pressure, or weight sensation on the chest, that lasts for more than 10 minutes. It can also radiate to other areas of the body, such as the back, arms or jaw.

When heart pain comes associated with other symptoms such as dizziness, cold sweats, difficulty breathing, intense headache, you should proceed to the emergency room immediately.

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Here are some of the most common causes for heart pain:

1. Excess gas

This is the most common reason for chest pain, and it has no connection with a heart problem. Excess gas on the bowels is very common problem in people who have constipation. The accumulation of gas pushes the abdominal organs up and can cause a stabbing pain in the chest.

2. Heart attack 

Even though this is the first concern of those who have chest pain, it's a rare cause, and it's more common in people with uncontrolled high blood pressure, very high cholesterol, diabetes and smokers.

The most common heart attack symptom is a tightening feeling, but it can also feel like a piercing, stabbing, or burning sensation that may radiate to the back, jaw, and arms, causing a tingling sensation.

3. Costochondritis

Costochondritis is characterized by an inflammation of the cartilage that connects the ribs to the sternum (a bone that is located in the middle of the chest). This can happen due to bad posture, arthritis, excessive physical exercise, or deep breathing.

Depending on the intensity of the symptoms, the pain that occurs due to costochondritis may be confused with a heart pain.

4. Anxiety

During an anxiety crises, there is an increase in rib muscle tension and increased heartbeat, which can result in tightening sensation or pain in the heart.

In addition to chest pain, other symptoms that can indicate an anxiety crises include rapid breathing, accelerated heart rate, nausea, changes to bowel functioning and excess sweating.  

5. Panic attack

Panic attack is a psychological disease in which there are sudden outbreaks of fear which cause symptoms such as breathlessness, cold sweats, tingling, loss of control, ringing in the ear, palpitations, and chest pain.

The pain felt during a panic attack is sometimes confused with a heart attack, however, there are some features that set them apart. The pain caused by a panic attack is usually acute and concentrated in the chest, while the pain caused by a heart attack is stronger, gets worse over time, can radiate to other areas of the body and it lasts more than 10 minutes. 

6. Pericarditis

Pericarditis is an inflammation of the pericardium, which is a membrane that coats the heart. This inflammation manifests through a very strong pain which can be easily confused with heart attack pain. Pericarditis usually appears after an infection or due to rheumatic diseases, such as lupus.  

7. Myocardial ischemia

Myocardial ischemia is a decrease in the amount of blood that passes to the cardiac muscle. This condition can cause a strong pain or burning sensation in the chest, which can radiate to the nape, chin, shoulders, or arms It can also cause palpitation to appear.

The main cause of myocardial ischemia is atherosclerosis, so the best way to avoid it is having an active lifestyle, maintaining healthy habits and controlling your diet by not eating fatty or sugary foods. In addition, the doctor may prescribe medication that eases the passage of blood as it acts on the plaque that obstructs the artery. 

8. Heart arrhythmia 

Heart arrhythmia is when the heartbeat is irregular, i.e., the heartbeat is too fast, or too slow. In addition to heart pain there can be other symptoms such as weakness, dizziness, malaise, paleness and cold sweats.

Arrhythmia can happen in healthy people as well as those who have an already established heart condition, and the main causes are high blood pressure, coronary disease, thyroid problems, intense physical activity, heart failure, anemia, and aging. 

What to do when you feel heart pain 

If heart pain lasts more than ten minutes or comes with other symptoms, it's important to go to the hospital.

Other symptoms that can alert to a serious condition include:

  • Tingling;
  • Dizziness;
  • Cold sweats;
  • Difficulty breathing;
  • Intense headache;
  • Nausea;
  • Feeling of tightening or burning;
  • Tachycardia;
  • Difficulty swallowing.

If there is any pre-existing cardiovascular disease, such as high blood pressure, it is very important to seek imediate medical assistance.