In contrast, noncardiac chest pain tends to feel like an intense stabbing or burning sensation just beneath the surface of the skin. Coughing, breathing, or moving can affect the intensity of noncardiac chest pain, while the severity of cardiac chest pain usually remains stable, even when resting. The symptoms accompanying chest pain can be an important indication of whether it is cardiac or noncardiac.
Coronary artery disease CAD , also called ischemic heart disease or coronary heart disease, occurs when fatty deposits build up in the arteries that supply blood to the heart muscle. Over time, these deposits can restrict blood flow, which can cause a type of chest pain called angina. CAD can also lead to heart attacks and heart failure.
People often describe angina as a feeling of pressure, squeezing, burning, or tightness behind the breastbone. This pain can spread to other parts of the body, including the arms, jaw, neck, and shoulders. Angina often occurs during physical activity, and stress can also bring it on. If the pain continues after rest, this can be a sign of a heart attack. People who are unsure whether they are experiencing angina or a heart attack should call immediately or go to the emergency room.
Myocarditis is a rare form of cardiovascular disease that causes inflammation of the heart muscle. This inflammation can lead to chest pain, heart failure, or sudden death. According to the National Organization for Rare Disorders , myocarditis commonly develops without an identifiable cause.
However, doctors often diagnose people with myocarditis following a viral or bacterial infection. Myocarditis produces symptoms similar to those of other heart conditions, such as chest tightness and fatigue. Leaning forward can help relieve chest pain resulting from myocarditis. People can inherit genes from their parents that increase their risk of developing HCM. However, HCM can also occur as a result of high blood pressure , diabetes , or thyroid disease.
Pulmonary hypertension refers to high blood pressure in the arteries that supply the lungs. Common symptoms include shortness of breath and chest pain, which may occur or worsen with physical activity. Over time, symptoms may become more frequent as the disease progresses. Pneumonia is a chest infection that causes the tiny air sacs inside the lungs to become inflamed and fill with fluid. A common symptom of pneumonia is chest pain that typically worsens when a person inhales deeply or coughs.
The chest pain can range from mild to severe. A peptic ulcer is an open sore in the lining of the stomach or small intestine. Bacterial infections and long-term use of nonsteroidal anti-inflammatory drugs can lead to peptic ulcers. Peptic ulcers can cause a painful burning sensation that starts in the abdomen and extends to the chest.
This pain can come and go and may get better when a person eats or takes an antacid. Costochondritis is an inflammation of the cartilage around the breastbone. This inflammation can cause tenderness and sharp chest pain that may feel similar to the pain of a heart attack.
The pain from costochondritis usually affects the left side of the chest, but it can sometimes affect both sides. Deep breathing, coughing, and physical activity may make the pain worse. Possible causes of costochondritis include severe coughing, chest injuries, infections, and overexertion.
Involuntary spasms or contractions of the food pipe can cause intense chest pain. They include over-the-counter drugs such as omeprazole Prilosec and prescription drugs such as pantoprazole Protonix. These drugs reduce the release of acid from the stomach lining.
In addition to causing heartburn, excess stomach acid can also cause bleeding sores ulcers in the stomach; these, too, are treated with PPIs, among other drugs. Thanks to these stomach-protecting effects, doctors sometimes prescribe PPIs for people who take drugs that increase the risk of bleeding — even if they don't have heartburn.
Factors that can boost your odds include an infection with Helicobacter pylori bacteria and routine use of nonsteroidal anti-inflammatory drugs NSAIDs such as ibuprofen Motrin, others and naproxen sodium Aleve, Anaprox, others. Some research suggests a possible problem with taking both a PPI and clopidogrel.
Two popular PPIs, omeprazole and esomeprazole Nexium , inhibit a liver enzyme that helps convert clopidogrel to its active form.
In theory, this could make clopidogrel less effective for heart attacks and stroke prevention. But large clinical studies have not revealed any meaningful differences. Still, anyone with lingering concerns about a possible interaction could take a different PPI, such as pantoprazole, which does not affect the liver enzyme. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
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