Heart Chest Pain

Causes of Heart Chest Pain

Cardiovascular conditions that result in chest pain should always be taken seriously as some of the causes are life threatening and require emergency medical attention. Heart chest pain may be severe and sudden with other signs and symptoms like dizziness, shortness of breath (dyspnea) and fainting spells. This should raise the warning flag to seek immediate medical attention.

At other times, chest pain due to heart conditions may not require urgent attention but without medical treatment at some point, these causes can complicate into life threatening situations. Some of the causes of chest pain may also cause breastbone pain as part of the heart lies behind this bone.

Angina Pectoris

Angina is the chest pain that occurs when insufficient oxygenated (oxygen rich) blood can reach your heart muscle. There are different types of angina which may occur at different times or under certain conditions. Angina is relieved by a number of drugs although it most rapidly responds to nitroglycerin. It can be indicative of an imminent heart attack. It is often described as a sudden crushing or sharp stabbing pain.

Myocardial Infarction (MI or Heart Attack)

This is one of the most serious causes of heart chest pain and may be preceded by angina. At other times, it strikes suddenly and can be severe and suffocating with pain radiating down the arm, up to the jaw, to the back or upper abdomen. Other symptoms may include dizziness, fainting spells, shortness of breath (dyspnea), sweating and nausea. A heart attack is potentially fatal and immediate medical attention is required.

Thoracic Aortic Dissection

This is a tear of the inner wall of the aorta, the large blood vessel that carries oxygen-rich blood away from the heart.  An aortic aneurysm may have been previously detected. In this case, the tear occurs in the part of the aorta that runs within the thoracic (chest) cavity. A severe, sharp or tearing pain may be felt along with other symptoms like a dry mouth, dizziness, nausea and vomiting, disorientation and confusion. The person may appear pale and cold and clammy to touch with shortness of breath (dyspnea) and a rapid, weak pulse. An aortic dissection is life threatening and requires immediate medical attention.


Pericarditis is the acute or chronic inflammation of the lining around the heart. The heart is encapsulated in a thin membraned sac known as the pericardium. Pericarditis may occur as a result of localized or generalized infections, certain types of autoimmune diseases, trauma, certain drugs and as a result of chronic conditions like kidney failure or hypothyroidism. It may also occur post-operatively (Dressler’s syndrome) like after cardiothoracic (open heart) surgery.

Pericarditis causes chest pain that is typically aggravated with breathing, when eating or lying down flat (supine). The pain may vary between a sharp stabbing pain and dull ache. Other symptoms may include a fever especially in the case of an infection, hiccups or coughing, dyspnea and dizziness. Any condition that may cause the heart to beat faster or press against surrounding structures is likely to aggravate the pain.


Myocarditis is the inflammation of the heart muscle. This often occurs as a result of an infection but may also be caused by certain toxic chemicals, pharmaceutical and narcotic drugs, alcohol abuse and certain types of autoimmune diseases. Myocarditis may also occur as a result of heart failure or may cause heart failure itself.

The chest pain can vary in intensity and often resembles a heart attack. Other symptoms may include a fever (infection), dyspnea, an abnormal heartbeat, leg swelling, swollen stomach (fluid accumulation) and fatigue. Certain causes of lung chest pain may lead to myocarditis as the heart tries to compensate for inadequate oxygen intake by beating harder or faster.

Rheumatic Fever / Heart Disease

Rheumatic fever is a an inflammatory condition which occurs after a Streptococcus infection, especially in infections like a strep sore throat. This can lead to inflammation of many parts of the body with the heart and brain inflammation leading to more serious complications. Rheumatic heart disease is when the heart becomes affected and damaged by this inflammation, particularly the valve(s) of the heart.

The heart chest pain in rheumatic heart disease varies in sensation and intensity but is usually accompanied by palpitations. Other symptoms include a fever, dyspnea and fatigue. Since rheumatic fever affects multiple systems, there will also be other symptoms like a skin rash, joint swelling and pain or uncontrollable body movements. This condition tends to affect children and teenagers although it can occur in younger adults as well.

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  • Juliet

    I’m having an ongoing problem with PVC’s, currently over 20-25 a minute. It’s very uncomfortable and makes it hard to go to sleep, stay asleep, or get through the day without exhaustion. I’ve had a stress echo done to check for valve problems, and the doctors all tell me the PVC’s are “benign.” Inderal doesn’t give me any relief. The last doctor said they are probably stress-related, and I was given a prescription for Xanax, something I don’t want to have to take on a regular basis, besides the fact that it doesn’t seem to help either. Do you have any suggestions for relieving the condition, perhaps something my doctors have been reluctant to suggest or recommend? This has gone on for weeks, and is almost unbearable.

    • Dr. Chris

      Hi Juliet

      A premature ventricular contraction usually occurs as a result of some other condition/cause. Identifying this cause is essential. Looking for therapies to ease the discomfort is not the solution to the problem as it will persist unless the cause is attended to. If it is stress related, then it is important to consider stress management or even counseling for this. It may help. The fact that the discomfort is becoming more frequent in the past few week, you will definitely need to be more cautious. Speak to your doctor about a referral to a cardiologist so that you can get specialist advice. You don’t give much details about yourself so it would be difficult to attempt to assess the possible cause which may be likely. This is why specialist medical attention is necessary.

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