Right Side Chest Pain Causes

Causes of Chest Pain on the Right Side

Broadly, chest pain may be either centrally located (pain in center of chest) or occur more laterally (side chest pain). Right sided chest pain may be due to the same causes that can affect the left side. Although cardiac chest pain is more likely to occur on the left side, it can occur on both sides or even just on the right side on it own. A pulmonary embolism is a cardiovascular condition that causes prominent right side chest pain, which is of sudden onset, very severe with symptoms similar to acute myocardial infarction (heart attack). Diseases of the lung and terminal airways , like infections and cancer, are more likely to occur on the right side due to its anatomical features (discussed below).

Chest Wall

Chest wall disorders may cause visible deformities and irregular features on the chest surface. The pain may also intensify upon deep pressure on the chest wall, movement or when breathing in deeply. Trauma is the leading cause of chest wall pain affecting any level of the wall (skin, breast, muscle, nerve, bone, cartilage, joint). Breast pathology is more common in women (female breast).

  • Skin
    • Herpes zoster (shingles)
    • Cellulitis
    • Paresthesia
    • Skin diseases
    • Acne vulgaris
    • Hematoma
  • Muscle
    • Muscle strain
    • Fibromyalgia
    • Myositis : infectious – Cosackie B virus (Bornholm’s disease), cytomegalovirus (CMV), Mycoplasma bacteria, Streptococcus pneumonia, toxoplasmosis, schistomsomiasis.
    • Myosistis : non-infectious – polymyalgia rheumatica, dermatomyositis
    • Torn muscle
    • Drugs and substances like statins and alcohol
    • Hematoma
  • Nerve
    • Nerve root compression (intercostal)
    • Shingles
    • Diabetic neuropathy
    • Referred pain from other surface lesions or deeper structures and organs of the chest or abdominal cavity
  • Bone
    • Fractures of the rib or clavicle (collarbone)
    • Osteoporosis
  • Cartilage and joints
  • Breast
    • Trauma
    • Mastitis
    • Breast abscess
    • Breast cancer
    • Menstruation
    • Pregnancy
    • Breast milk engorgement

Lung and Pleura

The right lung is more prone to lung pathology like infections due to airborne pathogen and cancer associated with cigarette smoking, air pollution and industrial toxins. This is due to anatomical differences between the right and left lungs – the right lung is larger, with a shorter, wider bronchus carrying air to the more extensive tracheobronchial tree.

Coughing (wet or dry), sputum/phlegm, shortness of breath (dyspnea) and abnormal breathing sounds may be present to varying degrees in most lung pathologies. A fever may be indicative of an infection, although night sweats may also occur in cancer. Coughing up blood (hemoptysis) is a serious sign that is present in severe lung infections and lung cancer.

  • Cancer
    • Lung cancer
      • Non-small cell lung cancer – squamous cell carcinomas, adenocarcinomas, large-cell undifferentiated carcinoma
      • Small cell lung cancer
    • Mesothelioma
  • Non-Infectious Inflammatory Conditions
    • Congenital – hypoplasia of the lungs, lobar overinflation, bronchial abnormalities, airway malformation
    • Atelectasis
    • Acute lung injury
    • Acute lung distress syndrome
    • Asthma
    • Bronchiectasis
    • Chronic bronchitis
    • Chronic interstitial lung disease (interstitial pneumonia)
    • Diaphragmitis
    • Pleurisy
    • Pulmonary embolism
    • Pulmonary infarction
    • Sarcoidosis

Abdominal Organs and Cavity

While the chest cavity and abdominal cavity are clearly separated by the diaphragm, it is not uncommon to experience pain in the chest cavity due to pathology with the abdominal cavity. In addition, many consider the chest cavity as the entire area lying under the ribcage. However, almost the entire liver lies behind the right ribcage, the superior pole of the kidney, transverse and ascending colon, part of the pancreas, gallbladder and even the stomach. Refer to Liver Pain Location and Kidney Pain Location.

For a list of causes of right side chest pain due to abdominal pathology, refer to the article on Right Upper Quadrant Abdominal Pain.