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Chest pain is a common symptom with a variety of possible causes, some benign and some serious. It can be difficult to determine the exact cause of chest pain, as it may stem from the heart, lungs, or gastrointestinal tract. While chest pain is often associated with heart attacks, it can also be caused by muscle soreness, which results from overuse, strain, or trauma to the chest muscles. The pain from muscle soreness is typically localized, tender, and worsens with specific movements. It is important to distinguish between chest pain and muscle soreness, as they require different treatments.
| Characteristics | Values |
|---|---|
| Musculoskeletal chest pain | Comes from the bones, muscles, and tissues that enclose the heart and lungs |
| Muscles affected | Chest muscles, tendons, or ligaments |
| Causes | Overuse, strain, or trauma to chest muscles |
| Infections, rheumatic diseases, injuries, or anxiety and depression | |
| Symptoms | Localized pain in a specific area, which may be tender or warm to the touch |
| Episodes of sharp or stabbing muscle spasms, followed by a lingering dull ache that worsens when taking a deep breath | |
| Worsens with certain movements or activities | |
| Treatment | Rest, heat therapy, or repositioning the body |
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What You'll Learn
Pulled or strained chest muscles
Chest pain can be scary, but it doesn't always indicate a heart attack or other cardiac issues. In fact, musculoskeletal chest pain, which comes from the bones, muscles, and tissues that enclose your heart and lungs, is a common cause of chest pain. This can be due to strained or pulled chest muscles, which are a tear in your muscle from overstretching or overuse. This can happen due to injury or trauma, such as a fall or car accident, or gradually through repetitive strain injuries from sports or other athletic activities. Certain illnesses may also cause muscle strain in the chest, for example, you may have pulled a muscle while coughing if you've recently had a chest cold or bronchitis.
Nearly half of all chest muscle strains occur in the intercostal muscles, which are responsible for helping you breathe. Other strained muscles may include the pectoralis major and pectoralis minor muscles. Strained chest muscles can cause sharp pain and tightness in your chest, as well as difficulty breathing, so it's important to see a healthcare provider for a proper diagnosis. They will determine if the strain is acute or chronic and assign a grade based on the severity of the injury.
Mild chest muscle strains can usually be treated at home with the RICE method: rest, ice, compression, and elevation. It's important to stop any activity that causes you to pull your chest muscle and to keep your chest elevated, especially at night. You can also take over-the-counter pain relievers such as ibuprofen or acetaminophen to reduce inflammation and pain. With proper care, mild strains can usually heal within a few weeks.
For more severe strains or if your symptoms aren't improving with home treatment, you should see your doctor. They may recommend physical therapy or exercises to correct muscle imbalances contributing to the strain. In some cases, surgery may be needed to repair torn muscles. Recovery time depends on the severity of the strain, with more serious injuries taking months to heal, especially if surgery is required.
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Musculoskeletal chest pain
Xiphoid syndrome is a rare condition that causes pain in the xiphoid process, which is the tip of the sternum. The pain may radiate to the chest or abdomen, or both. Infections and injuries can irritate the xiphoid process. Pleurodynia is inflammation of the chest muscles due to a viral infection. It can cause episodes of sharp or stabbing muscle spasms, followed by a lingering dull ache that worsens when taking a deep breath.
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Heart attack
While muscle ache can cause chest pain, it is important to distinguish between this and the symptoms of a heart attack. Chest pain is a common symptom of a heart attack, but not all chest pain is cardiac-related. Musculoskeletal chest pain can come from muscles, bones, tendons, ligaments, or joints in the chest wall. It may be caused by injury, rheumatic disease, or respiratory illness. Emotional stress or anxiety can also cause chest discomfort.
However, if you are experiencing chest pain, especially if it is severe or persistent, it is important to seek medical attention to rule out any cardiac issues. Heart-related chest pain, or angina, is typically described as a pressure, squeezing, or clenching sensation. It may spread to the neck, jaw, or down the arm and may be accompanied by sweating, nausea, or shortness of breath. Angina is a symptom of heart disease and can be a precursor to a heart attack.
If you are experiencing central or left-sided chest pain, especially with nausea or a cold and clammy feeling, it could indicate a heart attack, and you should seek immediate medical attention. While the classic symptom of a heart attack is the feeling of an "elephant on your chest," not everyone experiences this. Sometimes, nausea, shortness of breath, or feelings of indigestion are the most prominent symptoms. People having heart attacks may also feel generally unwell, cold, and clammy, and they often have an inherent sense that something is wrong.
It is important to note that not all chest pain is caused by a heart attack. Musculoskeletal chest pain can often be treated with conservative measures such as ibuprofen, warm compresses, and rest. Acid reflux-related chest pain can usually be relieved with antacids or medications like famotidine or omeprazole. However, if you are experiencing any concerning symptoms or if your chest pain is new and severe, it is always best to seek medical advice to rule out any cardiac issues.
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Gastrointestinal conditions
While chest pain is often associated with cardiac conditions, it can also be caused by various gastrointestinal issues. Gastrointestinal problems can trigger chest pain, leading to confusion due to the overlapping symptoms they share with heart-related issues.
One of the primary causes of gastrointestinal chest pain is gastroesophageal reflux disease (GERD), where the backflow of stomach acid into the oesophagus creates a burning sensation that radiates to the chest. This can often be mistaken for a heart attack. Esophageal spasms, which involve abrupt contractions of the oesophageal muscles, can also lead to severe chest pain. Additionally, conditions such as peptic ulcers, gastritis, and functional dyspepsia may cause discomfort that mimics cardiac pain, especially when acid irritates the stomach lining.
Other gastrointestinal conditions that can cause chest pain include gallbladder disease, pancreatitis, and irritable bowel syndrome (IBS). Gallbladder disease, specifically cholecystitis, involves the inflammation of the gallbladder, often caused by gallstones obstructing the bile duct. This obstruction can lead to a buildup of bile, resulting in pain and nausea. Pancreatitis, an inflammation of the pancreas, can lead to severe abdominal pain that sometimes extends to the chest area. IBS, a condition characterised by abdominal pain, bloating, and altered bowel habits, can also cause chest pain.
It is important to note that chest pain, whether cardiac or non-cardiac, should not be ignored and medical attention should be sought immediately. A physician can perform tests and examinations to determine the underlying cause and develop an appropriate treatment plan.
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Pleurodynia (Bornholm disease)
Pleurodynia, or Bornholm disease, is characterised by sudden chest pain due to inflammation of the diaphragm and chest muscles. It is caused by a viral infection, with the most common strain being the Coxsackie B virus, although other enteroviruses have been associated with the disease. The illness typically lasts 3-5 days and is most common in children and adolescents. It is usually accompanied by a fever, headache, sore throat, nausea, and vomiting. The pain is often described as sharp or stabbing muscle spasms, followed by a lingering dull ache that worsens when taking a deep breath.
Bornholm disease is a clinical diagnosis that differentiates the illness from other causes of pain, such as appendicitis or myocardial infarction. It is characterised by spasmodic pain, fever, and relapses. Tachycardia and arrhythmias have been detected using an electrocardiogram (ECG), and murmurs, rubs, and pericardial effusions have been found upon physical examination.
The illness typically has a benign prognosis and complete regression is expected. However, some rare complications may occur, including myocarditis, respiratory failure, hepatic necrosis with coagulopathy, disseminated intravascular coagulopathy (DIC), aseptic meningitis, pericarditis, and pleurisy. Another uncommon complication is orchitis, which manifests as unilateral testicular pain and swelling following the expected symptoms of Bornholm disease.
The disease is spread primarily through the faecal-oral route, with the virus shed in large amounts in the faeces of infected persons. It can also be transmitted through respiratory secretions and oral-oral contact. In previous cases, the disease has been spread by sharing drink containers and has been contracted by laboratory personnel working with the virus.
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Frequently asked questions
Yes, muscle soreness can cause chest pain. Muscle soreness can result from overuse, strain, or trauma to your chest muscles. It is often localized to a specific area, which may be tender or warm to the touch. It is usually described as an ache or stiffness that worsens with certain movements or activities.
Chest pain can stem from various sources, including heart issues, lung problems, and gastrointestinal conditions. It can be caused by a heart attack, angina, heartburn, infections, inflammation, and panic attacks. Muscle soreness, on the other hand, generally doesn't come with other symptoms. It is typically related to muscle overuse or injury.
Chest pain can be a symptom of a heart attack or other serious condition, especially if it's accompanied by shortness of breath, sweating, nausea, dizziness, or pain radiating to other parts of the body. If you experience severe or sudden chest pain, seek immediate medical attention.
Muscle soreness is typically localized to a specific area and may be tender or warm to the touch. It often worsens with certain movements or activities and improves with rest, heat therapy, or repositioning. Chest pain, on the other hand, may feel like pressure, squeezing, or fullness and can spread to other areas of the body, such as the neck, jaw, or arms.
