Chest pain is a frequently reported symptom among individuals affected by COVID-19, and its presence can be a source of concern. Understanding the reasons behind this chest discomfort is important for those experiencing it. This article explores factors that can contribute to chest pain during or after a COVID-19 infection.
Direct Impact on Respiratory and Cardiovascular Systems
The SARS-CoV-2 virus can directly affect the lungs and heart, leading to distinct types of chest pain. One common pulmonary complication is pneumonia, where the infection causes inflammation and fluid buildup within the tiny air sacs of the lungs. This can result in chest pain or tightness, often accompanied by shortness of breath. The pain from pneumonia may be persistent and can worsen as the infection progresses.
Inflammation of the pleura, the thin membranes lining the lungs and chest cavity, is known as pleurisy. This condition can cause sharp, stabbing chest pain that often intensifies with deep breaths, coughing, or movement. Pleurisy can be a direct inflammatory response to COVID-19.
The virus can also impact the cardiovascular system, leading to inflammation of the heart muscle (myocarditis) or the sac surrounding the heart (pericarditis). Myocarditis often presents as chest pain that might feel like pressure, tightness, or a sharp ache, sometimes radiating to other areas, along with shortness of breath and irregular heartbeats. Pericarditis typically causes chest pain that can come on quickly and may worsen when breathing deeply or lying down. While these heart-related conditions are less common, they are serious complications of COVID-19.
Musculoskeletal and Nerve-Related Pain
Chest pain from COVID-19 can also originate from the muscles, bones, and nerves within the chest wall, rather than internal organs. Costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone, is a recognized cause. This condition leads to localized tenderness and sharp pain, which can be exacerbated by movement, pressure, or persistent coughing. The pain can be sharp or dull.
General muscle aches, or myalgia, can also affect the chest wall due to the body’s widespread inflammatory response to the virus. Frequent coughing associated with COVID-19 can strain the muscles between the ribs, contributing to this discomfort. This muscular pain might feel sore to the touch and can worsen with stretching or movement. Additionally, inflammation or irritation of the nerves located between the ribs (intercostal nerves) can cause sharp, localized chest pain.
Blood Clot Formation
COVID-19 can increase the risk of blood clot formation, a condition known as hypercoagulability. This heightened tendency for blood to clot is often a result of the immune response to the infection and systemic inflammation. The virus can promote clotting, particularly in severe cases.
A pulmonary embolism (PE) occurs when a blood clot travels to the lungs and blocks blood flow. This is a serious complication that can cause sudden, sharp chest pain, which may worsen with breathing. Individuals experiencing a pulmonary embolism might also develop shortness of breath and a rapid heart rate.
Other Contributing Factors and When to Seek Help
Beyond direct physical effects, the psychological impact of illness can also manifest as chest pain. Anxiety and stress, common during a COVID-19 infection, can lead to sensations of chest tightness or pain, even in the absence of physical damage to organs. This type of chest pain might onset rapidly and can sometimes mimic more serious conditions.
Gastroesophageal reflux disease (GERD) can also be a source of chest discomfort. While not directly caused by the virus, GERD symptoms, such as heartburn-like chest pain, might be experienced during or after a COVID-19 infection. This can occur independently or be exacerbated by the overall stress on the body.
Chest pain can persist in some individuals as a symptom of Long COVID, extending for weeks or even months after the initial infection. This lasting pain may be due to ongoing inflammation or continued stress on the heart and lungs. Nearly 15% of Long COVID patients experience cardiovascular symptoms, with chest pain being the most common among them.
It is important to seek medical attention for chest pain. Individuals should call emergency services immediately if they experience sudden, severe chest pain that persists, especially if it is accompanied by severe shortness of breath, new confusion, inability to wake or stay awake, or pale, gray, or blue-colored skin, lips, or nail beds. For less severe but persistent or concerning chest pain, consulting a doctor is advisable to determine the underlying cause and appropriate course of action.