Chest pain experienced while breathing is a common symptom that can range from a mild, temporary discomfort to a sign of a serious underlying health condition. This type of pain originates from various bodily systems, including the heart, lungs, musculoskeletal structures of the chest wall, and even the digestive tract. While many instances of chest pain with breathing are not life-threatening, understanding the potential causes is important for determining when medical attention is necessary.
Common Non-Urgent Causes
Musculoskeletal issues frequently cause chest pain that worsens with breathing or movement. Conditions like costochondritis involve inflammation of the cartilage connecting the ribs to the breastbone, leading to sharp, aching, or pressure-like pain that can intensify with deep breaths, coughing, or pressing on the affected area. Similarly, strained intercostal muscles, located between the ribs, or bruised or broken ribs can cause localized chest pain that increases with deep inhalation or coughing.
Minor respiratory conditions can also lead to painful breathing. Pleurisy, for example, is an inflammation of the pleura, the tissue layers surrounding the lungs, which typically causes sharp chest pain that worsens when breathing in or coughing. Bronchitis, an inflammation of the bronchial tubes, can also contribute to chest discomfort.
Gastrointestinal issues, such as acid reflux or gastroesophageal reflux disease (GERD), are another common source of chest pain that can mimic heart-related symptoms. This pain, often described as a burning sensation behind the breastbone, can worsen after eating or when lying down, and may feel sharp or tender. Anxiety or panic attacks can manifest as chest tightness or pain, sometimes accompanied by shortness of breath, making it feel worse with breathing.
Potentially Serious Causes
Some causes of chest pain with breathing are serious and require immediate medical evaluation. Cardiovascular issues are a significant concern, as chest pain can indicate conditions like a myocardial infarction, commonly known as a heart attack, where blood flow to the heart muscle is blocked. Angina, a symptom of coronary artery disease, causes chest pain due to reduced blood flow to the heart, often described as squeezing, pressure, or tightness, and can sometimes spread to the arms, neck, jaw, or back. Pericarditis, inflammation of the sac surrounding the heart, typically causes sharp, stabbing chest pain that may worsen with deep breaths or when lying flat, and can feel better when sitting up and leaning forward.
Pulmonary issues also present with chest pain during breathing. A pulmonary embolism involves a blood clot blocking an artery in the lung, causing sudden shortness of breath and chest pain that worsens with inhalation. A pneumothorax, or collapsed lung, occurs when air leaks into the space between the lung and the chest wall, leading to sudden chest pain and shortness of breath. Pneumonia, a lung infection, can cause chest pain that intensifies with breathing or coughing, along with a cough and fever.
Other rare but life-threatening conditions include aortic dissection, a tear in the body’s main artery, the aorta. This condition often presents with sudden, severe chest or upper back pain described as a tearing or ripping sensation, and can extend to the legs.
When to Seek Medical Attention
Recognizing when to seek medical attention for chest pain is crucial. Immediate emergency care is necessary if the chest pain is sudden and severe, or if it is accompanied by other concerning symptoms. These red flags include pain that radiates to the arm, jaw, neck, or back, as well as shortness of breath, sweating, nausea, dizziness, or a feeling of pressure or tightness in the chest. A very rapid heartbeat, very low blood pressure, confusion, or loss of consciousness alongside chest pain also warrant emergency medical assistance. If chest pain persists after an injury, or lasts more than 15 minutes, it is also a cause for immediate concern.
In situations that are not immediate emergencies, consulting a doctor soon is advisable. This includes persistent pain that does not improve, pain accompanied by fever, cough, or phlegm, or pain that worsens over time. Unexplained weight loss or fatigue alongside chest pain should also prompt a visit to a healthcare professional.
Understanding Diagnosis
Diagnosing the cause of chest pain when breathing typically begins with a thorough medical history and physical examination. The healthcare professional will ask detailed questions about the pain’s characteristics, such as its onset, duration, and any accompanying symptoms. They will also inquire about personal health history and listen to heart and lung sounds.
To further investigate, various diagnostic tests may be employed:
An electrocardiogram (ECG or EKG) assesses heart activity.
A chest X-ray identifies lung issues or structural problems.
Blood tests check for cardiac enzymes or inflammation markers.
CT scans or MRIs are used for detailed imaging, especially for pulmonary embolism or aortic dissection.
Endoscopy examines the esophagus and stomach for gastrointestinal causes.
Accurate diagnosis is important for effective treatment.