Right Side Chest Pain: 7 Causes and What to Do

Medical review: Dr. Clarisse Bezerra
Family Doctor
October 2021

In most cases, pain on the right side of the chest is a temporary symptom that happens due to conditions that are not serious, such as too much stress, muscle strain or acid reflux.

However, chest pain, whether on the right or the left side, can happen for many reasons, such as problems in the digestive system, problems in the lungs, and even problems in the heart. In all cases, pain should be assessed and treated as needed.

If your pain occurs frequently, is very intense, worsens with time, or if it comes with other symptoms such as tingling in the arm and face, difficulty breathing, or fainting, call an ambulance or proceed to a hospital immediately. These symptoms can be a sign of a life-threatening problem. 

The most common causes of right-sided chest pain include:

1. Stress and anxiety

Excess stress and anxiety are two conditions that can lead to a panic attack, and they can cause very similar symptoms to a heart attack, like sudden chest pain. Usually the pain is felt more in the middle of the chest with a panic attack, but many times it can radiate to the right side of the body.

Along with chest pain, other symptoms that can emerge are shallow breathing, breathlessness, tingling in the hands and feet, and sweating. Unlike a heart attack, a panic attack is more common after a very stressful situation and the chest pain tends to disappear within a few minutes.

What to do: The best way to alleviate discomfort caused by a panic attack is to try to calm down by regulating your breathing relaxing any tense muscles. It might help to go somewhere quiet and drink a cup of valerian or chamomile tea. If the chest pain is still strong or if you suspect a heart attack, call an ambulance or go to the hospital immediately.

2. Muscle strain

A strained muscle is another common cause of right-sided chest pain and it usually happens one or two days after performing any activity that uses the chest muscles more intensively. These activities can be intentional (e.g. exercising at the gym), or unintentional (e.g. painting a ceiling).

Using strong force in the chest region can cause temporary damage to muscle fibers, and although this may not cause pain immediately, it may become painful after a few days. Other symptoms of strained chest muscles include increased pain with palpation, slight swelling, and difficulty moving your arms.

What to do: Applying ice to the affected region for 15 to 20 minutes, three to four times a day, will help with pain relief. Also, you can do a light massage over the affected region with an anti-inflammatory cream. If the pain does not improve within three days, assessment by a general physician or a physiotherapist is recommended, as more specific treatment may be needed.

3. Acid reflux (or GERD)

Acid reflux, also known as heartburn, is a common condition that occurs when stomach acid travels up the esophagus, causing a burning sensation (particularly after eating). This discomfort can sometimes be painful, and can be felt in the general chest area or on the right side.

Gastroesophageal reflux disease (GERD) is generally accompanied by other symptoms such as a frequent need to burp, a bitter taste in the mouth, feeling like there’s a lump in the throat, and a dry cough.

What to do: Depending on the severity, reflux symptoms can be relieved through simple diet changes, such as avoiding large meals and avoiding fatty and spicy foods. However, there are cases where medication to block stomach acid may be necessary. If the discomfort does not improve with diet changes, a consult with a gastroenterologist is recommended to start adequate treatment.

4. Costochondritis

Costochondritis is a less common problem but it can cause intense chest pain. Typically pain is felt in the middle of the chest, but it can radiate to the right or left side.

This condition happens when the cartilage that connects the sternum to the ribs becomes inflamed due to strong pressure changes, intense coughing, or even bad posture. Costochondritis causes sensitivity in the mid-chest area, and pain usually worsens when you cough or take a deep breath. 

What to do: Costochondritis is a temporary problem that tends to improve after a few days without any specific treatment. However, stretching exercises and applying ice to the affected area for 15 to 20 minutes, three to four times a day, can decrease inflammation and relieve discomfort. Anti-inflammatory medication may also help with swelling.

5. Gallbladder or liver inflammation

The gallbladder and liver are two organs of the abdominal cavity that are located on the right side of the body. When they become inflamed or are not functioning correctly, pain can be felt on the right side. Although it is more common for pain to be felt in the abdominal area, in some cases, pain can radiate to the chest too. 

In addition to pain, problem with the gallbladder or the liver can produce other symptoms like vomiting, loss of appetite, general malaise, and jaundice. 

What to do: If you suspect you have gallbladder inflammation or a liver problem, it’s important to consult a gastroenterologist for assessment and to start appropriate treatment. Gallbladder inflammation is usually quite serious, especially if a gallbladder duct is obstructed by a stone. In these cases, the pain is very strong, and fever and vomiting can occur. If this happens, go to the hospital immediately.

6. Lung problems

Various problems in the lungs can cause pain in the chest region, and it is especially felt with breathing. In addition to pain, there may also be coughing, shortness of breath, shallow breathing and fever.

Lung problems are more common after chest injury (e.g. from a car accident) or in people who have chronic heart or pulmonary diseases. 

What to do: Chest pain due to problems with the lungs can be a sign of a serious problem such as pleurisy, pneumonia, pneumothorax, or even a pulmonary embolism. If you suspect you have a lung problem, proceed to the hospital immediately. Exams like a thoracic x-ray may be ordered to identify the cause and start appropriate treatment.

7. Heart problems

When you get any chest pain, one of the main concerns is that it may be a sign of a heart problem. Although, it is not very common for right-sided chest pain to be caused by the heart, it is possible for heart problems to cause pain that radiates to the right side, especially if the heart muscle is inflamed.

Heart problems are more commonly seen in elderly people, people with other chronic problems or patients who are hospitalized for serious infections. Heart-specific pain is usually very intense and causes a sensation of tightness in the chest. Additionally, other symptoms can occur, like palpitations, cough, difficulty breathing and fainting. 

What to do: If you suspect that your chest pain is related to a heart problem, proceed to the hospital or call for an ambulance immediately, so that a diagnosis can be confirmed and treatment can be started.

When to go to the doctor

Many times, right-sided chest pain disappears after a few minutes and if it does, there’s no reason to worry. However, assessment by a doctor is the only way to really identify the underlying cause. It's best to go to a hospital if:

  • The pain is very intense or gets worse with time
  • The pain lasts for more than 15 minutes
  • Other symptoms appear such as difficulty breathing, fever or fainting

In addition, elderly people and those with chronic problems, especially respiratory or heart disease, should be assessed by a doctor, as the pain may indicate that the condition has worsened, and treatment may need to be adjusted.

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Atualizado por Tua Saude editing team, em October de 2021. Medical review por Dr. Clarisse Bezerra - Family Doctor, em November de 2020.

References

  • NHS. Acute cholecystitis. Available on: <https://www.nhs.uk/conditions/acute-cholecystitis/#Symptoms>. Access in 28 Apr 2020
  • NHS. Chest pain. Available on: <https://www.nhs.uk/conditions/chest-pain/>. Access in 28 Apr 2020
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.