8 Causes of Chest Pain That Aren't a Heart Attack

When we think of chest pain, we usually think about heart attacks.

According to the American Heart Association (AHA), a heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely, which can be fatal. Heart attack pain can last for hours if untreated.

A heart attack is the most serious symptom of coronary artery disease (CAD), the most common type of heart disease. CAD can produce a type of chest pain called angina.

Angina may feel like pressure or squeezing in your chest and typically happens when you are physically exerting yourself. The discomfort can also be felt in your:

• Shoulders
• Arms
• Neck
• Jaw
• Abdomen
• Back

Angina pain may even feel like heartburn, but it is short-lived and typically doesn't last longer than 10 minutes.

If you're experiencing chest pain, it's important to get it checked out, ASAP. Don't hesitate to call 911, especially if it's a new symptom you've never had before, the pain comes and goes, or the pain worsens.

All chest pain should be checked out by a healthcare professional. They can determine if it's angina, heart attack pain, or something else.

Chest pain isn't always caused by a heart attack. Some causes can be mild, like heartburn, others can be dangerous, like pancreatitis.

Heartburn

You might be wondering how someone could mistake the symptoms of acid reflux for a heart attack, but there's a reason why it's called heartburn, after all.

Gastroesophageal reflux occurs when a person's stomach contents—including the gastric acids that help break down food—back up into the esophagus, the tube that connects the throat and stomach.

Stomach acid is highly acidic, hence, the burning sensation behind your breastbone; on the pH scale, it scores about a 1 according to the Environmental Protection Agency (EPA) falling somewhere between battery acid and vinegar.

Our stomachs are lined with protective membranes that shield it from the corrosive effects of acid, while our esophagus is not.

The occasional reflux is fairly common and probably nothing to worry about, but if you're experiencing it twice a week or more, you may have gastroesophageal reflux disease (GERD).

Left untreated over time, GERD can cause asthma, chest congestion, and a condition called Barrett's esophagus, which may increase your chances of developing a rare type of cancer, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Muscle Strain

It's possible for someone to mistake a strained chest muscle for something more serious, like a heart attack, said Christine Jellis, MD, PhD, a Cardiology Specialist at Cleveland Clinic.

"I had a patient who came in with chest pain, and he was worried he was having a heart attack," said Dr. Jellis. "After taking his history, I learned he had moved [to a new house] and hadn't lifted heavy furniture in years. But he did the right thing, coming in."

Healthcare providers don't expect people to be able to tell the difference between a heart attack and a pulled chest muscle, said Dr. Jellis, but a good way to check is that if you can press on the wall of the chest and it feels even more painful, it's more likely to be a musculoskeletal injury than a problem with your heart.

Costochondritis

Costochondritis is an inflammation of the tissue (cartilage) connecting your ribs to your breastbone, according to MedlinePlus.

It's a common and benign (or non-threatening) cause of chest wall pain. But if it's new to you, it's a good idea to get it checked out by a medical professional anyway.

Although healthcare providers can't always pinpoint what triggered the condition, the causes can range from viral infections to chest injuries.

Typically, people feel a type of pressure on their chest wall and—similar to a strained muscle—a tenderness when they press on the area.

In this case, a healthcare provider will probably start by taking your medical history and doing a physical exam. "A physician is going to want to rule out cardiac and other serious issues first," said Dr. Jellis. "It'll most likely be a diagnosis by exclusion."

If you do have costochondritis, the pain typically goes away in a few days or weeks; taking over-the-counter painkillers can help.

Shingles

The virus that causes chickenpox lingers in your body long after the spots have faded. In fact, the varicella-zoster virus can reactivate in adulthood (usually in people older than 50) as a disease called shingles.

The first symptoms include itching and burning skin. If the area over the chest is affected, someone might mistake this new pain for a heart attack or other cardiac issue, said Salman Arain, MD, an interventional cardiologist at Houston and the Memorial Hermann Heart & Vascular Institute-Texas Medical Center.

A few days later, however, the telltale rash can appear, followed by blisters.

If you think you have shingles, call a healthcare provider ASAP. Antiviral medications can lessen the pain and shorten the duration of the symptoms, but only if you take them within 72 hours of the rash appearing.

If it's too late to take antivirals, a healthcare provider can prescribe a prescription painkiller.

Pericarditis

Pericarditis is a condition where there is inflammation in the layers of tissue that surround the heart (called the pericardium).

In 80%–85% of cases, pericarditis is caused by a viral infection, as reported in a 2022 review published in Current Cardiology Reports.

Other causes include bacterial infections, which are less common, and fungal infections, which are rare, according to MedlinePlus. Although there can be other causes as well.

Pain is present in most cases and is described as sharp or stabbing. The pain is located on the left side or front part of the chest, but it can also occur in the neck, shoulder, back, or abdomen.

It's more intense with lying down, breathing deeply, coughing, or swallowing, and it improves with sitting up and leaning forward, which is unique to this condition.

Although pericarditis is usually harmless, according to Dr. Arain, it can really impact your quality of life.

A healthcare provider may diagnose your condition after ordering a CT scan, EKG, or chest X-ray.

Chances are, however, your pericarditis will clear up in a few days or weeks simply through resting or taking over-the-counter pain medicine like ibuprofen, which also helps quell inflammation.

Pancreatitis

Just because a person's chest pain isn't related to a heart attack doesn't mean that it isn't dangerous. One example: acute pancreatitis—the sudden inflammation of the pancreas, which is located just behind the stomach, says NIDDK.

"Intense abdominal pain can radiate up to the chest," said Dr. Arain. "And the pain from pancreatitis is usually a deep-seated, intense pain."

Oftentimes, pancreatitis occurs when gallstones (hard, pebble-like pieces of material usually made of hardened cholesterol, according to NIDDK) trigger inflammation in the pancreas—something that's more likely to occur in women than men.

If you think you have pancreatitis, get medical attention right away; you'll probably have to stay in the hospital for a few days to get antibiotics, IV fluids, and pain medication.

A healthcare provider will also want to do blood work and order other tests, like a CT scan or abdominal ultrasound.

Pleuritic chest pain

Chest pain can have a number of pulmonary (lung) causes. Because the lungs and heart are both located in the chest, it can be easy to confuse the origin of the pain.

Pleuritic chest pain occurs when the lining of your lungs (the pleura) becomes inflamed. This can cause "sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling," according to a 2017 article published in the American Family Physician.

While not related to a heart attack, this type of chest pain can also be serious and is another reason you'll want to get your symptoms checked out by a medical professional.

Pulmonary embolism is the most common serious cause of pleuritic chest pain and is life-threatening.

Pulmonary embolism occurs when there is a blockage in a lung artery. This blockage can damage the lungs and cause low oxygen levels in your blood, which can damage other organs as well, according to MedlinePlus.

Pneumonia can also cause pleuritic chest pain. Pneumonia is an infection of the lungs and can range from mild to severe, depending on the cause, according to MedlinePlus. Chest pain from pneumonia will occur when you breathe or cough.

If you've had some type of injury or trauma to your chest, a broken or bruised rib can also cause chest pain. Breathing, coughing, and moving your upper body can be very painful if you've injured your rib.

Panic Attack

Having a panic attack can certainly feel like a heart attack; people often believe they're dying when they are having one.

In addition to chest pain, symptoms can include a pounding heart, sweating, shaking, nausea, dizziness, and a feeling of going crazy. It's your body's fight-or-flight response kicking in, according to the American Psychological Association.

Panic attacks tend to crop up suddenly with no warning. People can experience them for a variety of reasons, including:

• Having a family history of panic attacks
• A history of childhood trauma
• Dealing with major life changes and ongoing stress (such as a serious illness of a loved one)
• Experiencing a traumatic event (such as a robbery or car accident)

If you think you've experienced a panic attack, it can be helpful to visit a healthcare provider. They can rule out any physical issues with your heart, which can help put you at ease.

A provider may also refer you to a mental health professional who can help you treat and manage your symptoms.