Pain in Middle of Chest: 6 Common Causes & When to Worry

Pain in the middle of the chest is a common symptom that can have various causes, ranging from mild conditions like gastritis to more serious issues like a heart attack. Middle chest pain is often due to less urgent conditions and is rarely linked to a heart attack.

One of the most frequent causes of pain in the middle of the chest is excess gas, which can mimic the sensation of a heart attack. Other conditions, such as costochondritis, gastritis, and stomach ulcers, can also lead to discomfort in the chest area, often accompanied by other symptoms like bloating, nausea, or heartburn.

If the pain persists or is accompanied by symptoms like shortness of breath or tingling in the arms, it’s essential to seek medical attention right away. In most cases, addressing the underlying condition, such as with anti-inflammatory medication or dietary changes, can provide relief and prevent further complications.

Common causes

Middle chest pain can be caused by: 

1. Excess gas

Excess intestinal gas is one of the most common causes of pain in the middle of the chest and can often be confused for a heart attack. Uncertainty about the cause of the pain can lead to anxiety, which can make the pain feel worse and reinforce the belief that it might actually be a heart attack.

Pain from excess gas is commonly seen in people with constipation, but it can also occur in other situations, such as after taking probiotics or when trying to resist the urge to have a bowel movement. Learn more about causes of gas accumulation in the intestines. 

Other symptoms: In addition to chest pain, you may also notice other symptoms of gas such as bloating or sharp abdominal pain. 

How to treat: You can massage your abdomen to help release trapped gas in the intestines and drink teas like fennel or cardamom tea, which can aid in absorbing gas.

Some medications, like simethicone, can help, but should be used only as directed by a healthcare provider. You can also check out these steps to getting rid of gas plus some natural home remedies.

2. Costochondritis

Sometimes, pain in the middle of the chest can occur due to costochondritis, which is inflammation of the cartilage that connects the ribs to the sternum (the bone in the middle of the chest). This pain often intensifies when pressing on the chest or when lying face down.

Other symptoms: A bruised feeling in the chest and pain that intensifies when pressing on the area, breathing, or coughing.

How to treat: Apply a warm compress on your sternum to help relieve pain. Treatment should involve anti-inflammatory medications prescribed by a healthcare provider. 

3. Heart attack

Although this is the first suspicion when chest pain is felt, heart attacks are not as common as believed to be and typically occur in people with risk factors like overweight, high cholesterol, or cardiovascular diseases like hypertension. 

Other symptoms: Normally, a heart attack will also cause additional symptoms like cold sweats, nausea or vomiting, pallor, shortness of breath, and a heavy left arm. The pain also tends to worsen over time, and may start off as a mild chest tightness. Understand the symptoms of a heart attack so that you can easily identify one. 

How to treat: If you suspect you are having a heart attack, proceed immediately to the hospital or call 911. 

4. Gastritis

Gastritis is inflammation of the stomach and is one of the most common causes of pain in the middle of the chest. It is common for the pain to start in the upper stomach and radiate to the middle of the chest or even the back. 

Gastritis is most frequent in people with unhealthy eating habits, and may also be associated with s stressful lifestyle, as excessive worrying can alter stomach pH. 

Other symptoms: Gastritis usually causes a full stomach sensation, lack of appetite, heartburn, and frequent burping.

Read more about the symptoms of gastritis and complete our online quiz if you suspect you may have gastritis. 

How to treat: To decrease stomach inflammation and relieve symptoms, you can drink water with a few drops of lemon or drink potato juice. Both of these methods help to increase stomach pH to reduce inflammation.

Gastritis can also be caused by an H. pylori infection, in which case it's important to consult a gastroenterologist, especially if the pain lasts more than 3 or 4 days. You may find these gastritis home remedies beneficial to complement your medical treatment. 

5. Stomach ulcers

In addition to gastritis, another common stomach problem that causes middle chest pain is a stomach ulcer. Generally, ulcers are a consequence of untreated gastritis that has injured the stomach lining and created open wounds.

Other symptoms: Ulcers cause a sharp pain that radiates to the back and chest. Other signs of an ulcer are frequent nausea, a heavy stomach, and vomiting, which may even contain small quantities of blood. Check out other common symptoms of ulcers. 

How to treat: You should consult your primary care provider if you think you may have an ulcer. It may be necessary to start medications that reduce stomach acid and protect the stomach lining, like pantoprazole or lansoprazole.

A light diet with easy-to-digest foods can help prevent worsening of the ulcer. See what foods are allowed and which should be avoided when treating an ulcer. 

6. Liver problems 

In addition to stomach problems, liver problems can also cause pain in the middle of the chest. Although liver pain is mostly felt on the right side of the abdomen, below the ribs, it is also possible for this pain to radiate to the middle of the chest. 

Other symptoms: It is common to also experience constant nausea, weight loss, headache, dark urine, and yellow skin or eyes. Read more about symptoms of liver disease that you should not ignore. 

What to do: If you suspect a liver problem, you should see your primary care provider for diagnosis and treatment if needed. 

When to worry

You should seek medical attention right away if you suspect a heart attack or any cardiac problems. It is always best to seek emergency care if there is suspicion or doubt, since this is a very serious condition. 

However, if this is not the case, it is recommended to see a doctor if the pain lasts for more than 2 days or if it is accompanied by: 

• Vomiting blood;
• Tingling in the arm;
• Yellow eyes and skin (jaundice);
• Difficulty breathing.

In addition, if you have risk factors like overweight or obesity, high cholesterol, or high blood pressure, and frequently experience middle chest pain, you should see your doctor for a follow-up.