Causes of chest pain
There are a number of different conditions that can cause chest pain. You should always seek medical advice to make sure you get a proper diagnosis.
Depending on your symptoms and circumstances, you may need further investigation.
Heart attack
A heart attack occurs when the blood supply to part of the heart is suddenly blocked.
Chest pain is more likely to be caused by a heart attack if it:
- lasts more than 15 minutes
- occurs while resting
Angina
Angina is a condition where the blood supply to the muscles of the heart is restricted.
Chest pain caused by angina is usually triggered by physical activity (exertion). It usually gets better with rest after a few minutes.
Pulmonary embolism
A pulmonary embolism is a blockage in the blood vessel that carries blood from the heart to the lungs. This can cause sharp, stabbing chest pain that may get worse when you breathe in. It can also be accompanied by:
- breathlessness
- a cough
- dizziness
- coughing up blood
Pericarditis
Pericarditis is inflammation of the sac surrounding your heart. This can cause a sudden, sharp and stabbing pain in your chest. It may also cause more of a dull ache. This pain usually gets worse when you lie down.
Lung conditions
Lung conditions that can cause chest pain include:
- pneumonia – inflammation of the lungs (usually caused by an infection)
- pleurisy – inflammation of the membrane surrounding the lungs (usually caused by an infection)
Conditions affecting the lungs can cause sharp chest pain that:
- gets worse when you breathe in and out
- is accompanied by other symptoms like coughing or breathlessness
If someone has severe pneumonia or pleurisy, they may also have symptoms like:
- rapid breathing
- confusion
Seek medical advice immediately if you or someone else has symptoms of:
- a heart attack
- angina
- a pulmonary embolism
- pericarditis
- pneumonia
- pleurisy
Other causes of chest pain
There are many other potential causes of chest pain, including:
- gastro-oesophageal reflux disease (GORD) - acid from the stomach comes up into the oesophagus (gullet) causing burning chest pain (heartburn) and an unpleasant taste in the mouth
- acute cholecystitis - inflammation of the gallbladder that can cause a sudden sharp pain in the upper right side of your tummy that spreads towards your right shoulder
- strained muscle - can cause chest pain that's painful and tender to touch
- costochondritis - inflammation in the cartilage that joins the ribs to the breastbone (sternum) that can cause pain, swelling and tenderness around the ribs
- panic attack or anxiety - can sometimes be accompanied by chest pain
Last updated:
01 November 2022
Without warning, there’s a sharp, stabbing pain in your heart. Um. That can’t be good, right?
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Chest pain is scary, and it can be serious. But a whole lot of things can cause stabbing pain in your chest, and some have nothing to do with your heart, says cardiologist Sapna Legha, MD.
Here’s what might be causing that breath-stopping pain — and when you should consider it an emergency.
What causes sharp pain in the heart?
Chest pain isn’t always as bad as you might think. A 2016 study in the Journal of the American Medical Association (JAMA) found that less than 6% of people who go to the emergency room for chest pain actually have a life-threatening problem.
That doesn’t mean you should ignore the pain, of course. It could signal something serious.
So what’s going on inside your ribcage? Dr. Legha points to some of the common causes of sharp chest pain.
Pulmonary embolism
Sharp chest pain could signal a pulmonary embolism, a clot that lodges in the lungs. Besides pain, symptoms can include shortness of breath, pale skin, racing heart and cough.
Gastrointestinal problems
Acid reflux, or gastroesophageal reflux disease (GERD), can cause a burning sensation in your throat or chest — classic heartburn. But sometimes, GERD can cause sharp chest pain and pressure, Dr. Legha says. So can esophagitis, an inflammation of the lining of the tube that connects the throat to the stomach.
With these conditions, pain is more likely after eating, exercising or lying down. You might also have a hard time swallowing.
Musculoskeletal problems
If you recently hauled a heavy box or worked out too hard at the weight gym, you might have developed a case of costochondritis — inflammation of the cartilage around the sternum. A bad case can cause significant pain.
Aortic dissection
This dangerous condition strikes when the layers of the aorta, the heart’s major blood vessel, tear apart. It feels like a sharp, tearing pain in your chest and back. Other symptoms include shortness of breath, fainting or dizziness, weak pulse and stroke symptoms.
This isn’t a sharp pain that eases after a minute, but pain you can’t ignore. (And you shouldn’t. It’s a 911 situation.)
Coronary artery disease
Coronary artery disease can cause a painful sensation in the chest called angina. But usually, that pain is described as heaviness, achiness, tightness or pressure, rather than a sharp, sudden blast of pain. “This type of pain is usually brought on by exertion and goes away with rest,” Dr. Legha says.
Heart attack
Typical heart attack pain is similar to the pain of coronary artery disease: A heaviness, tightness or pressure. But some people experience atypical symptoms, especially women and people with diabetes, Dr. Legha says. It’s unusual for a heart attack to cause pain without other symptoms, though, such as shortness of breath, cold sweats, nausea, dizziness or lightheadedness.
When does chest pain = emergency?
Unfortunately, it can be tough to pinpoint the cause of chest pain on your own. So how do you know if it’s an emergency?
Chest pain but no other symptoms: Make a doctor’s appointment
If you’re young and otherwise healthy, and the pain eases up after a few minutes, it’s probably not urgent, Dr. Legha says — especially if you don’t have any other symptoms.
“If you’re stable and not clutching your chest in pain, you can probably just schedule an appointment with your primary care doctor,” she says. “Not every pain needs to be worked up in the emergency department.”
Chest pain with other symptoms: 911 or the ER
If you have other symptoms associated with serious heart and lung problems (like shortness of breath, a lot of sweating or nausea), call 911 or get yourself to the ER.
Chest pain with other heart disease risk factors: 911 or the ER
Similarly, play it safe if you have risk factors for heart disease — high blood pressure, high cholesterol, diabetes, a history of smoking or a family history of heart problems. Err on the side of caution and see a doctor right away, she adds. “It’s always better to be safe and have it evaluated.”