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Chest Pain & Tightness in Chest

The chest houses two major organs in the body—the heart and the lungs. Our focus here is on chest pain that is not caused by a heart attack, but is related to other causes. The emergence of COVID-19 has created a renewed awareness of several cardiac conditions that cause chest pain, tightness in chest and other symptoms similar to those of a heart attack:

  • Myocarditis, or inflammation of the myocardium muscle of the heart. This condition sometimes mimics the symptoms of a heart attack: chest pain, irregular heartbeat, fatigue, and difficulty breathing. Those who have had COVID-19 are especially vulnerable to myocarditis, and athletic-type individuals age 18 to 30 are at greater risk for sudden death from myocarditis. A painless, non-radiation cardiac MRI can be easily performed to see if myocarditis is present.
  • Pericarditis, or inflammation of the sac around the heart, is also caused by a virus but is not as deadly as myocarditis. It creates symptoms similar to angina and sharp pains in the upper neck and shoulder muscle.

The chest is also subject to pain from injury or trauma and to pain from medical conditions that originate in the lungs and gastrointestinal areas.

Chest Pain Symptoms

  • Chest pain
  • Shortness of breath or difficulty breathing
  • Irregular heartbeat or heart palpitations
  • Dizziness
  • Fatigue
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Chest Pain Causes

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  • Accident, injury, or fall
  • Muscle strain
  • Fractured or inflamed ribs
  • Shingles
  • Anxiety or panic attacks
  • Other heart conditions—hypertrophic cardiomyopathy, mitral valve prolapse, and coronary artery dissection.
  • Lung conditions—pleurisy, pneumonia, pulmonary embolism, pneumothorax, pulmonary hypertension, asthma, COPD.
  • Gastrointestinal conditions—gastroesophageal reflux disease; esophageal spasms, hypersensitivity, and rupture or perforation; stomach ulcers; hiatal hernia; gallbladder problems.

Chest Pain Treatment & Chest Pain Relief - When to See a Doctor

Seek immediate medical attention if:

  • You have had COVID-19.
  • Your pain is severe or intolerable.
  • Your pain is from an accident, injury, or fall.

Chest Pain from a Heart Attack

The term chest pain triggers concerns about a heart attack and, clearly, unexplained chest pain is a major symptom that should be addressed immediately by calling 9-1-1. Not everyone, especially women, experiences chest pain when having a heart attack, so individuals must be aware of all signs and symptoms of this life-threatening condition.

Call 9-1-1 if you have any signs and symptoms of a heart attack, such as:

  • Chest pain
  • Pressure, squeezing, or tightness in the chest
  • Chest pain that radiates to the left arm, neck, jaw, shoulder, or back
  • Sudden sharp chest pain with shortness of breath
  • Rapid heart rate or rapid breathing
  • Nausea, dizziness, confusion, or excessive sweating
  • Very low blood pressure or heart rate

Women should be aware of additional heart attack symptoms that are different from men:

  • Upper abdominal pressure or discomfort
  • Unusual fatigue
  • Back pain
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