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pain may arise and subside every few minutes or over several days. The cause
may be related to the heart, the muscles, the digestive system, or
psychological factors.
Underlying causes of chest pain may be mild, as in the
case of acid reflux.
Or, they may be serious and indicate, for example, a heart attack.
It is important to recognize warning signs and look for accompanying symptoms.
In this article, we explore the possible causes of chest
pain that comes and goes. We also describe how to tell when the pain is
heart-related, and when to see a doctor.
Is it a sign of
something serious?
Pain in the chest that comes and
goes may signal a problem with the heart, respiratory system, or digestion.
Also, in some people, it occurs during panic attacks.
There is no way to accurately self-diagnose chest pain
based on symptoms alone. See a doctor if chest pain keeps coming back, gets
worse, or accompanies other symptoms.
Pain that lasts for weeks or months is unlikely to be
caused by a life-threatening emergency. The issue is more likely related to the
muscles or skeletal structure.
Heart problems are less likely to
cause pain that:
- lasts for
only a few moments
- is relieved
by taking medication
- goes away
when taking a deep breath
- only
affects a specific point on the chest
- is relieved
when the area of the chest is massaged
Causes of chest pain that comes and goes
Many types of chest pain come and go. Even the pain of a
heart attack may temporarily get better, then return.
To better understand the cause of chest pain, look
carefully for other symptoms, and keep in mind any risk factors for medical
conditions.
Below are common causes of chest pain:
Gastrointestinal
problems
A wide variety of gastrointestinal problems can lead to
pain in the chest or near the ribs. For example:
- Acid reflux
can cause a burning sensation in the chest.
- Gallstones can
cause sudden, intense pain that lasts for several hours, disappears, and
returns.
- Ulcers can
cause pain that comes and goes.
When a person has acid reflux, chest pain tends to be more
intense shortly after a meal. Also, it may be worse after consuming alcohol or
fatty foods.
If a person suspects that chest pain is related to a
stomach or liver issue, it is important to see a doctor. However, this type of
pain does not usually signal an emergency.
Muscle pain
Muscle pain caused by tension, an injury, or a chronic
pain syndrome often underlies chest pain.
Symptoms of muscle pain vary greatly. The pain may be:
- sharp or
dull
- shooting or
throbbing
- radiating
outward or concentrated in one spot
Chest pain is more likely to be muscle-related if it:
- gets better
with massage
- gets worse
when a person inhales sharply and suddenly
- feels
similar to muscle pain experienced in the past
Panic attack
Chest pain can be a frightening
symptom of a panic attack, and it may make a person feel more anxious. The pain
can be similar to that of a heart attack. Some people with panic attacks may feel
as if they are dying.
These attacks often go away with deep breathing. In some
cases, they may last for only a few minutes.
If the pain does not go away, it can be difficult to
distinguish a panic attack from a heart attack without the help of a doctor.
Respiratory
infection
Respiratory infections can cause chest pain, especially
when they also cause frequent coughing.
Some people develop a condition called pleurisy following
a respiratory infection. Pleurisy is inflammation of
the pleura, which is the tissue that wraps around the outside of the lungs.
See a doctor if chest or lung pain lingers after a
respiratory infection.
Angina
Angina is
pain or discomfort in the chest that occurs when the heart does not get enough
blood. People with angina may feel tension, pressure, or a squeezing sensation
in the chest. The pain may also radiate to the jaw.
The pain of angina is similar to that of a heart attack,
and angina one risk factor for the condition.
Angina is usually a symptom of coronary
heart disease (CHD), which occurs when the arteries become
clogged. CHD is also a risk factor for a heart attack. Anyone who suspects that
they have it should see a doctor.
Heart attack
Sudden, intense pain in the chest may indicate a heart
attack or cardiac arrest. These result when faulty electrical impulses or
blockages stop blood from reaching the heart.
Warning signs of a heart attack include:
- pain in the
center of the chest
- a feeling
of crushing pressure on the chest
- pain that
lasts longer than a few minutes
- pain that
radiates to the shoulder, neck, arms, back, or jaw
- nausea,
dizziness, or shortness of breath
Symptoms may differ, based on sex. Women tend to
experience nausea and dizziness, shortness of breath, and back or jaw pain more
frequently than men, for example, and they may not have the classic symptom of
pain in the center of the chest.
A heart attack is a medical emergency. If a person
suspects that they are having one, or if they experience any new, unexplained
chest pain, they should contact emergency services right away.
Individuals with cardiovascular risk factors, such as CHD,
a history of heart attacks, obesity,
or diabetes,
are more likely to have heart attacks.
Lung issues
Problems with the lungs, including infections and pneumonia,
can lead to chest pain and shortness of breath.
Lung disorders are serious. Anyone who suspects that they
have one should seek medical care within 1–2 days. However, being unable to
breathe or experiencing intense, lung-related chest pain is considered a
medical emergency.
Mastitis
This refers to an infection in breast tissue. Mastitis can
be intensely painful. A person may experience swelling, shooting or sharp pains
in the breasts or chest, and a fever.
Mastitis is common during breast-feeding. The infection
may clear up on its own, though some people require antibiotics or
a hospital stay.
Pulmonary
embolism
A pulmonary
embolism is a blockage in a blood vessel that leads to the
lungs. An embolism occurs when a blood clot has broken loose, often from the
legs. If a person has a blood clot in a leg, they may experience pain in the
area.
Pulmonary embolisms can result in intense chest pain and
shortness of breath. They are life-threatening medical emergencies.
Breast-feeding
This can lead to pain in the chest and around the breasts.
The following factors may be responsible:
- enlargement
of the breasts
- the
let-down reflex
- mastitis
- hearing a
baby cry
Some people experience breast or nipple pain as the body
adjusts in the first few weeks of breast-feeding. If the pain is mild and comes
and goes, waiting it out is fine.
Talk to a doctor if the pain is intense or lasts for
several weeks.
How to know if
chest pain is heart-related
Chest pain should be evaluated by
a physician. It is not always possible to self-diagnose the cause based on
symptoms alone.
Chest pain is more likely to be heart-related if a person
has:
- cardiovascular
risk factors
- a history
of heart
disease
- shortness
of breath
- pain that
does not improve with medication or massage
- pain that
gets worse over time
Heart issues are unlikely to cause chest pain that:
- improves
with massage or painkillers
- feels
similar to earlier pain that was not heart-related
- occurs with
symptoms of problems unrelated to the heart
When to see a doctor
A doctor should evaluate any recurring chest pain. If the
pain keeps coming back, see a doctor within a few days.
Chest pain that disappears may have been caused by a minor
infection, a muscle spasm, or a similar issue.
Seek emergency medical care if the pain is:
- intense and
does not go away
- getting
gradually worse
- accompanied
by dizziness, trouble breathing, or shortness of breath
- accompanied
by a squeezing or crushing sensation in the center of the chest
- lasting for
more than a few minutes
Outlook
Most chest pain is not caused by a heart attack. However,
prompt medical care can be lifesaving. Even when the cause is a minor issue, seeking
immediate care can eliminate any anxiety.
Only a doctor can accurately identify the cause of chest
pain, so it is essential to seek a diagnosis.
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