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If you’re experiencing any form of chest pain, you should seek medical attention immediately. But while it’s tempting to frantically worry you’re having a heart attack every time your chest hurts, this isn’t always the case.
“Chest pain doesn’t necessarily mean a heart attack or even heart pain,” says Jeremy Pollock, MD, a Board-Certified Cardiologist at the University of Maryland St. Joseph Medical Center. “Once your doctor or care provider confirms that the chest pain is not life-threatening — not a heart attack, tearing of the aorta (aortic dissection) or blood clot in the lungs (pulmonary embolism), for instance — he or she will further assess to see what other issues may be the source of your pain,” Pollock tells us.
Possible causes of chest pain that aren’t a heart attack range in severity. Pollock discusses nine of them with us below.
1. Pneumonia
If you’re experiencing chest pain, the culprit might be pneumonia, an infection in the lungs. “Pneumonia causes pus or fluid buildup that can lead to chest pressure or pain,” explains Pollock.
Similarly, Pollock notes that bronchitis and pleurisy (inflammation of the membranes surrounding the lungs), can cause chest discomfort.
2. A collapsed lung
“A collapsed lung, also known as pneumothorax, often causes sudden sharp pain in the chest and breathing difficulties that can mimic a heart attack,” says Pollock.
Moreover, a collapsed lung can also cause crepitus of the chest. This is a weird kind of crackling or popping sensation that can easily be confused with a heart attack, explains the cardiologist — especially for someone who has never experienced either condition.
3. Pulmonary hypertension
Another cause for chest pain might be pulmonary hypertension or high blood pressure in the lungs.
“[Pulmonary hypertension], caused by the blockage of blood vessels in the lungs, can cause chest pain, lightheadedness and shortness of breath — all symptoms that easily mimic a heart attack,” Pollock tells us.
4. Lung cancer
Lung cancer causes cells to divide uncontrollably in the lungs. This leads to the growth of tumors that eventually make breathing difficult.
“Lung cancer that has spread into the chest wall may cause chest pain,” Pollock says.
5. Heartburn or digestive issues
Any kind of pain from or surrounding the digestive tract can cause chest pain, says Pollock.
“[These can] include reflux, ulcers, esophageal spasms, and hernia, and can cause chest discomfort akin to a heart attack,” the cardiologist says.
6. Pericarditis
Pericarditis — or the inflammation of the lining around the heart — can cause sudden, sharp pain in the chest. “This is the result of the “rubbing together” of the layers of the pericardium, as when coughing or moving,” Pollock explains.
He notes that myocarditis — the inflammation of the heart muscle itself — causes similar pain, as well as shortness of breath.
7. A muscle pull
Sometimes, a good old-fashioned muscle pull or bruised rib can cause pain in the chest area, which (though painful) comes as a relief.
In addition, Pollock notes that a condition called costochondritis — or an inflammation of the ribs or cartilage — can also be very painful in the chest region.
8. A rheumatologic infection
“Rheumatologic infections like shingles, lupus, and sarcoidosis (an autoimmune inflammatory disease), can cause severe discomfort in the chest area,” explains Pollock.
These infections can lead to chest pain and shortness of breath.
9. Stress
It’s important not to discount the psychological impact on chest pain. “Anxiety or panic attacks are among the most common causes of chest pain,” Pollock says.
According to the cardiologist, anxiety-related chest pain can be managed, but it’s important to check with your doctor to rule out other possible causes first.
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Each of the conditions listed above can present with chest pain, but each has varying signs and symptoms that help care providers distinguish one from the other.
“It’s essential that you seek professional advice as soon as possible, to help determine or rule out those life-threatening conditions and provide timely treatment and effective pain relief,” Pollock concludes.
