Chest pain is a symptom that can have a variety of causes, ranging from mild to life-threatening. It can be caused by problems with the heart, lungs, gastrointestinal system, or musculoskeletal system. Chest pain can be described as a dull ache, sharp stabbing pain, pressure, burning sensation, or tightness. It is important to seek medical attention immediately if chest pain is severe, lasts longer than a few minutes, is accompanied by other symptoms such as shortness of breath, nausea, or dizziness, or if there is a history of heart disease or other risk factors. Prompt diagnosis and treatment are important to prevent complications and improve outcomes.

Chest pain has many possible causes, all of which need medical attention.

Heart-related causes

Examples of heart-related causes of chest pain include:

• Heart attack. A heart attack results from blocked blood flow, often from a blood clot, to the heart muscle.
• Angina. Angina is the term for chest pain caused by poor blood flow to the heart. This is often caused by the buildup of thick plaques on the inner walls of the arteries that carry blood to the heart. These plaques narrow the arteries and restrict the heart's blood supply, particularly during physical activity.
• Aortic dissection. This life-threatening condition involves the main artery leading from the heart (aorta). If the inner layers of this blood vessel separate, blood is forced between the layers and can cause the aorta to rupture.
• Inflammation of the sac around the heart (pericarditis). This condition usually causes sharp pain that gets worse when breathing in or lying down.

Digestive causes

Chest pain can be caused by disorders of the digestive system, including:

• Heartburn. This painful, burning sensation behind the breastbone occurs when stomach acid washes up from the stomach into the tube that connects the throat to the stomach (esophagus).
• Swallowing disorders. Disorders of the esophagus can make swallowing difficult and even painful.
• Gallbladder or pancreas problems. Gallstones or inflammation of the gallbladder or pancreas can cause abdominal pain that spreads to the chest.

Muscle and bone causes

Some types of chest pain are associated with injuries and other problems affecting the structures that make up the chest wall, including:

• Costochondritis. In this condition, the cartilage of the rib cage, particularly the cartilage that joins the ribs to the breastbone, becomes inflamed and painful.
• Sore muscles. Chronic pain syndromes, such as fibromyalgia, can cause persistent muscle-related chest pain.
• Injured ribs. A bruised or broken rib can cause chest pain.

Lung-related causes

Many lung disorders can cause chest pain, including:

• Blood clot in the lung (pulmonary embolism). A blood clot that gets stuck in a lung (pulmonary) artery can block blood flow to lung tissue.
• Inflammation of the membrane covering the lungs (pleurisy). This condition can cause chest pain that worsens when you inhale or cough.
• Collapsed lung. The chest pain associated with a collapsed lung typically begins suddenly and can last for hours and is generally associated with shortness of breath. A collapsed lung occurs when air leaks into the space between the lung and the ribs.
• High blood pressure in the lung arteries (pulmonary hypertension). This condition affects the arteries carrying blood to the lungs and can produce chest pain.

Other causes

Chest pain can also be caused by:

• Panic attack. If you have periods of intense fear accompanied by chest pain, a rapid heartbeat, rapid breathing, profuse sweating, shortness of breath, nausea, dizziness and a fear of dying, you may be having a panic attack.
• Shingles. Caused by a reactivation of the chickenpox virus, shingles can produce pain and a band of blisters from the back around to the chest wall.

Chest pain treatment varies depending on what's causing your pain.

Medications

Drugs used to treat some of the most common causes of chest pain include:

• Artery relaxers. Nitroglycerin — usually taken as a tablet under the tongue — relaxes heart arteries, so blood can flow more easily through the narrowed spaces. Some blood pressure medicines also relax and widen blood vessels.
• Aspirin. If health care providers think that your chest pain is related to your heart, you'll likely be given aspirin.
• Thrombolytic drugs. If you are having a heart attack, you may receive these clot-busting drugs. These work to dissolve the clot that is blocking blood from reaching the heart muscle.
• Blood thinners. If you have a clot in an artery feeding your heart or lungs, you'll likely be given drugs that interfere with blood clotting to prevent more clots from forming.
• Acid-suppressing medications. If chest pain is caused by stomach acid splashing into the esophagus, a health care provider may suggest medications that reduce the amount of acid in the stomach.
• Antidepressants. If you're having panic attacks, your health care provider may prescribe antidepressants to help control symptoms. Talk therapy, such as cognitive behavioral therapy, also might be recommended.

Surgical and other procedures

Procedures to treat some of the most dangerous causes of chest pain include:

• Angioplasty and stent placement. Chest pain that is caused by a blockage in an artery feeding the heart is typically treated with angioplasty. The doctor inserts a catheter with a balloon on the end into a large blood vessel, usually in the groin, and guides the catheter to the blockage. The doctor inflates the balloon to widen the artery, then deflates it and removes the catheter. A small wire mesh tube (stent) is often placed on the outside of the balloon tip of the catheter. When expanded, the stent locks into place to keep the artery open.
• Bypass surgery. During this procedure, surgeons take a blood vessel from another part of the body and use it to create an alternative route for blood to go around the blocked artery.
• Emergency dissection repair. You may need emergency surgery to repair an aortic dissection — a life-threatening condition in which the artery that carries blood from the heart to the rest of the body ruptures.
• Lung reinflation. If you have a collapsed lung, a health care provider may insert a tube in the chest to reinflate the lung.