Chest pain is NOT always equal to Heart Attack!

Updated: Mar 13, 2021

One of the most common reasons patients go to the emergency room is chest pain. When you have chest pain, the big fear is that you may be experiencing a heart attack. But the fact is that very few patients that go to the emergency room with chest pain, actually have a heart issue.


If you think carefully chest is comprised of several structures. Skin, soft tissue, bones, blood vessels, nerves, lungs, heart, esophagus, trachea, lymphatic system etc. Hence, any issue with any of these structures may cause chest pain.



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Following are the common causes of chest pain, some emergent, some urgent and some non-urgent. Understanding these causes can help you understand what steps to take if you ever have chest pain. However, when in doubt, seek immediate medical help so that you can get appropriate timely medical attention and treatment.


Heart:


Blockage in arteries supplying heart can cause what we call heart attack. Typically the chest pain is on the left side and may radiate to left arm, jaw or back. However many times in females and diabetics especially, patients complain of heartburn or indigestion or other atypical symptoms when they have heart attack. Inflammation of the heart muscle or the coverings of heart can also cause chest pain.


Blood vessels:


Ballooning (aneurysm) of aorta (major artery) may cause severe chest pain that radiates to back especially when it is leaking or about to rupture. Blood clots in lung blood vessels can also cause chest pain.


Trachea (wind pipe):


When we breathe air it goes through nose/mouth to voice box to trachea which in turn branches in to numerous small airways in the lung tissue. Inflammation or infection of trachea can cause chest pain.


Lungs:


Several conditions of lungs like pneumonia, asthma/COPD, bronchitis, collapsed lungs, fluid around the lungs, blood clot in lung vessels, tumor or cancer can cause chest pain.


Esophagus (food pipe):


Esophagitis (inflammation of esophagus) which is caused by acid injury from reflux (heartburn) is the most common cause of chest pain from esophagus. Other causes include narrowing of esophagus, tumor or cancer, ulcer, spasm, infection/ inflammation to name the important ones.


Lymphatic system:


Enlarged lymph nodes, lymphomas and other lymph node conditions can cause chest pain.


Soft tissue/ bones:


Inflammation of soft tissue, arthritis of the small joints in chest between the ribs and chest bone, muscle injuries, soft tissue or bone tumors, shoulder issues are the common causes of chest pain.


Nerves:


Pinched nerves or irritation of the nerves can cause chest pain.


Skin:


Infection of the skin, cysts, shingles, cancer, other rash are the common causes of chest pain.


Breast:


In females, disorders of breast like breast lump, cyst, cancer, fibrocystic disease, infection etc. can cause chest pain.



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