Left sided chest pain tends to cause significant stress as it is often associated with grave consequences like that of a heart attack. This is especially true if the pain is sudden and severe. However, there are various causes of chest pain on the left side that may not be as a result of life threatening medical conditions. Similarly, mild left sided chest pain that develops gradually may not be as innocuous as it would be seem.
In order to assess the seriousness of left sided chest pain, as is the case with pain anywhere in the body, it is important to identify concomitant signs and symptoms. Chest pain, whether left, right or central, that is associated with shortness of breath, paleness, sweating, dizziness and/or fainting spells should always be treated as a medical emergency, irrespective of the severity or medical history of the patient.
Causes of Chest Pain on the Left Side
Many of the same causes as that of right side chest pain also needs to be considered in left chest pain. However the concern lies with left sided chest pain that may be a result of cardiovascular conditions like angina, a heart attack, pericarditis, pulmonary embolism or aortic dissection.
Heart and Blood Vessels
- Angina Pectoris
- Pain occurs as a result of ischemia – tissue injury due to hypoxia.
- It is often triggered by stress or physical activity and relieves upon rest and the use of nitrates.
- Heart Attack (Myocardial Infarction)
- Pain occurs as a result of death of heart muscle – infarct.
- Sudden, severe central and left sided chest pain that radiates down the left arm, jaw, neck, shoulder or abdomen.
- Other symptoms may include shortness of breath, sweating, nausea, paleness, dizziness or fainting and anxiety.
The differences between pain due to angina and a heart attack is discussed further under Angina or Heart Attack Pain.
- Pain is due to the inflammation of the lining around the heart (pericardium).
- Sharp chest pain that exacerbates upon lying down and coughing and may ease when sitting upright or bending forward.
- Other symptoms may include shortness of breath, dry cough, fatigue or low grade fever.
- Pulmonary Embolism
- Pain arises as a result of a blockage in the arteries of the lung which may lead to death of lung tissue.
- Like a heart attack, the pain is of a sudden onset and very severe.
- Other symptoms may include shortness of breath, cough with bloody sputum, wheezing, sweating, paleness to cyanosis (bluish tinge of the skin), dizziness or fainting.
- Aortic Dissection (Dissecting Aneurysm)
- Pain is due to a collection of blood in the in the wall of the aorta thereby causing the middle and inner layers to separate. A rupture may occur.
- The pain is sudden and severe and radiates to the neck, back, jaw or abdomen, similar to a heart attack
- Other symptoms may include shortness of breath, dizziness and fainting, weakness and numbness of any part of the body, sweating, paleness, nausea and/or vomiting.
Heartburn is a burning chest pain due to acid reflux. Although heartburn is usually centrally located (occurring in the middle of the chest), it is often mistaken for cardiac pain. It is not uncommon to experience the pain slightly to the left but behind the breastbone (sternum). The differences between heartburn and a cardiac condition is described under Cardiac vs Non-Cardiac Chest Pain.
Tenderness at the site (upon applying pressure), visible deformities and irregular features of the chest wall, skin rashes and pain upon breathing deeply and when moving are common features of chest wall pain. Some of the causes include :
- Skin – acne vulgaris, shingles
- Muscle – muscle strain, torn muscles, tendons or ligaments
- Bone – fracture ribs
- Cartilage and/or joints – costochondritis and other causes of joint pain
- Nerve – nerve root compression, shingles, referred pain
- Breast – mastitis, breast cancer
Other causes of pain due to disorders of the chest wall are discussed under right side chest pain.
Respiratory tract infections are a common cause of acute chest pain. It often presents with a cough, sputum, shortness of breath and fever. Non-infectious respiratory conditions may present with similar conditions, although a fever is usually not present. However, a low grade fever may be seen in autoimmune conditions or cancer.
- Bronchitis, acute or chronic
- Cancer – lung, pleura
- Lung abscess
Other causes of pain due to disorders of the respiratory tract are discussed under right side chest pain.
Various organs of the abdominal cavity lie under the lower left ribcage, especially when lying down, and is described as as chest pain. This includes conditions affecting the stomach, left kidney, spleen, left lobe of the liver and pancreas. The signs and symptoms may vary depending on the location and function of the organ. These symptoms may include lower left chest pain that tends to aggravate with eating or after eating and upon inhaling.
Some of the causes of left sided chest pain as a result of the abdominal organs includes :
- Hiatal hernia
- Peptic ulcer
- Kidney pain
- Spleen pain
- Splenic flexure syndrome