Chest pain during physical activity can be a concerning symptom. While such discomfort can sometimes indicate a serious underlying condition, it can also stem from more benign sources. This article provides general information regarding potential causes, not medical advice.
Musculoskeletal and Digestive Causes
Chest pain during exercise often originates from the musculoskeletal system or the digestive tract. Muscle strain is a common culprit, affecting pectoral or intercostal muscles. These can become sore from repetitive movements or unaccustomed exertion, leading to a dull ache or sharp pain that worsens with specific movements or pressure.
Costochondritis, an inflammation of the cartilage connecting ribs to the breastbone, is another musculoskeletal cause. It causes sharp, localized pain that intensifies with deep breaths or direct pressure. While uncomfortable, costochondritis is usually harmless and often resolves on its own.
Digestive issues can also mimic chest pain, with heartburn being a prime example. Heartburn occurs when stomach acid flows back into the esophagus, a condition known as gastroesophageal reflux disease (GERD). Exercise, especially activities involving bending or lying down, can trigger or worsen GERD symptoms by increasing abdominal pressure. This can lead to a burning sensation in the chest, often accompanied by a sour taste or regurgitation.
Respiratory and Other Non-Cardiac Causes
Beyond musculoskeletal and digestive issues, the respiratory system can also contribute to chest discomfort during exercise. Exercise-induced bronchoconstriction, also known as exercise-induced asthma, causes airways to narrow during physical activity. This narrowing leads to symptoms like chest tightness, wheezing, coughing, and shortness of breath, typically occurring five to twenty minutes into or after vigorous exercise.
Anxiety or panic attacks can also manifest during exercise, causing physical symptoms including chest pain. During an episode, individuals may experience a rapid heart rate, hyperventilation, dizziness, and chest tightness or pressure. While the discomfort is real, it relates to the body’s physiological response to intense anxiety, not a physical problem with the heart or lungs. The sensation can be alarming but does not indicate cardiac damage.
Less directly, dehydration or electrolyte imbalances can sometimes lead to muscle cramps, including in the chest wall. While not a primary cause of chest pain, severe muscle spasms from these imbalances could contribute to discomfort.
Potential Cardiac Concerns
When chest pain occurs during exercise, its potential cardiac origin warrants careful consideration. Angina is chest pain or discomfort that arises when the heart muscle does not receive enough blood. This reduced blood flow is typically due to narrowed coronary arteries.
Stable angina is predictable, often triggered by exertion or stress, and usually subsides with rest or medication. Unstable angina is more serious and unpredictable; its pain may occur at rest, be more severe, or last longer, and it doesn’t always respond to usual treatments. Both forms can cause pressure, squeezing, fullness, or tightness in the chest. This discomfort may also radiate to the left arm, neck, jaw, or back.
Irregular heart rhythms, known as arrhythmias, can also manifest as chest discomfort or palpitations during physical activity. While many are benign, some indicate underlying heart conditions affecting pumping efficiency. The sensation might be described as a fluttering, pounding, or skipped beat, occasionally accompanied by unease or pain in the chest.
A myocardial infarction, commonly known as a heart attack, is a severe medical emergency caused by a complete blockage of blood flow to part of the heart muscle. Although less common during exercise in otherwise healthy individuals, it can occur. Symptoms include intense chest pain (crushing pressure), shortness of breath, cold sweats, nausea, and pain radiating to the arm, jaw, or back. Recognizing these signs immediately is crucial, as a heart attack requires urgent medical intervention.
When to Seek Professional Medical Advice
Understanding when to seek professional medical advice for chest pain during exercise is important. Certain “red flag” symptoms warrant immediate medical attention. These include chest pain accompanied by severe shortness of breath, dizziness, lightheadedness, or fainting spells. Excessive sweating, nausea, or vomiting alongside chest pain also prompt urgent medical evaluation.
Pain that radiates to the arm, neck, jaw, or back is another serious indicator requiring prompt assessment. Any sudden onset of severe chest pain, or pain that does not subside with rest, should be considered an emergency. These symptoms can suggest a serious cardiac event requiring rapid diagnosis and treatment. Delaying care could have significant consequences.
Avoid self-diagnosing the cause of chest pain, especially during exercise. A healthcare professional can conduct a thorough medical evaluation, including physical examinations, medical history review, and diagnostic tests like an electrocardiogram (ECG), stress tests, or blood work. Seeking a medical opinion is particularly important if the pain is new, severe, recurrent, or if existing health conditions increase cardiac risk.