Chest pain (left and right): causes and what can be

Chest pain is a symptom that usually concerns us, but the causes can be diverse. Recognizing what has caused or is causing the condition is essential to prevent and prevent more serious complications.

Sporadic, transient and moderate pain often poses no risk. However, in some cases it can be related to serious cardiovascular diseases. Thus, if left untreated, it can evolve or even lead to death.

Check out what conditions can trigger this symptom and how to treat it!


What is chest pain?

Chest pain, or chest pain, is a symptom often associated with angina or heart attack , severe cardiovascular disease. However, it can also be caused by psychiatric disorders or diseases that affect the stomach, esophagus, lung and rib cage (skeleton and muscles).

A study carried out in 2000, by the University of Michigan, in the USA, evaluated 400 patients with frequent chest pain and found that only 11% had heart problems.

The research diagnosis showed that in 53% of the volunteers there were no definite causes for pain and in the other 36% the symptoms are caused by problems in the muscles or esophagus.

Still, chronic non-communicable diseases, as heart disorders fit, account for 72% of deaths in Brazil, so symptoms such as tightness or chest discomfort should not be ignored.

The intensity of the pain can vary from mild discomfort to the feeling of tightness, pressure or burning in the chest. In severe cases, the pain spreads to the neck, jaw, back and arms.

The most recommended is to go to the hospital when the pain lasts for more than 20 minutes or is associated with other symptoms, such as dizziness, cold sweats, difficulty breathing and headache .

What causes chest pain?

Chest pain can be caused by several diseases or changes that affect the esophagus, stomach, lung, heart and rib cage (skeleton and muscles). Muscle pain and tenderness in the joints are the most common causes. But even gases can be to blame for the nuisance!

The diseases of greatest concern are heart diseases, which affect the left side of the chest and can lead to death if there is no adequate assistance.

Other causes of severe chest pain

  • Arthritis and rheumatoid arthritis;
  • Arterial hypertension;
  • Fibromyalgia;
  • Aortic valve stenosis;
  • Herpes Zoster;
  • Myocarditis;
  • Cardiomyopathy;
  • Changes in the aorta, such as calcification of the aorta;
  • Complication in the veins or aortas.

What is left chest pain?

Chest pain is not the same regardless of the side. When it is stronger or only affects the left side, it may indicate some specific health conditions. Among the most common are:

Heart attack

In infarction , chest pain is constant and spreads to the left arm, neck and jaw, for more than 20 minutes. It is usually accompanied by numbness in the limbs on the left side, nausea, sweating, difficulty breathing and vomiting.


Costochondritis is an inflammation in the cartilage that connects a rib to the sternum bone. Symptoms include swelling and aggravated pain when lying down, taking a deep breath or coughing. The pains that costochondritis causes in the chest are similar to those of a heart attack.


Angina pain is caused by the reduction of blood in the heart, altering the functioning of the organ. It is located in the center of the chest, described as pressure, tightness, burning, discomfort or a sensation of shock.

It can be stable, the result of excessive effort, and unstable, originating even in a state of rest or light physical activities. It is usually accompanied by shortness of breath, pallor, hypotension and excessive sweating.

Cardiac ischemia

Cardiac ischemia is the decrease in blood flow through the arteries of the heart. It is the first sign of a heart attack, causing shortness of breath, palpitations, tightness in the chest, tingling in the arms and neck on the left side.

It can cause chest pain from its chronic form, when fat accumulates in the arteries, or transient, when it occurs in times of stress .

Cardiac arrhythmia

The inadequate frequency of the heart rhythm, which can be very fast, very slow or irregular, is called cardiac arrhythmia . The picture presents risks of not allowing the heart to pump enough blood to supply the body, which can damage essential organs, such as the brain and the heart.

In addition to chest pain, cardiac arrhythmia may be associated with other symptoms, such as tiredness , weakness, dizziness , malaise, fainting, shortness of breath, pallor and cold sweat.


Arteriosclerosis consists of the thickening and loss of elasticity of the artery wall – vessels that carry blood and oxygen to the brain, heart and other parts of the body.

It is a disease that causes an increase in blood pressure and is caused by the accumulation of fat and other substances inside the arteries. It is predominant in the male population over 50 years old.

What can be pain in the right chest?

When chest pain happens on the right side, there are other possibilities. There are some inflammations and disorders that can cause this characteristic pain, such as gallbladder problems, pericarditis, organ inflammation, etc.

It is always worth remembering that the pain can be due to several conditions, serious or not, persistent or transient. Therefore, an accurate diagnosis is always needed. Among the conditions that may be causing chest pains are:

Gallbladder disorders

Gallstones or cholecystitis (inflammation of the gallbladder) can cause chest pain and other symptoms in parallel, such as fever , nausea, vomiting and poor appetite. The pain is usually sharp and sudden, which spreads to the belly and shoulder on the right side.

Inflammation of the organs

The most common inflammations that cause chest pain on the right side are: gastritis (inflammation of the stomach), hepatitis (inflammation of the liver) and pleurisy (inflammation of the pleura, membrane that covers the lung).


Inflammation of the pericardium, the membrane that covers the heart, is called pericarditis. It starts with a sharp pain in the chest and spreads to the back. The symptoms also manifested with the disease are: dry cough , difficulty in breathing, fever, fatigue and anxiety .

What can be chest pain when breathing?

Chest pain when breathing can be caused by a number of different reasons. It may be associated with muscle injuries, inflammation of the lungs, lung disorders and even psychosomatic pain, as it is related to anxiety , stress and panic attacks.

In general, among the most associated conditions are:

Muscle injury

Chest pain when breathing can be a symptom of muscle injuries or fractures, infections and aggression in the ribs. Severe coughing can also cause pain in the area.

Thus, when breathing and requiring movement of the injured site, pain occurs. However, it is not always simple to realize that it is a muscle pain.

In general, the discomfort and sensitivity tend to decrease gradually, if it is a minor injury or inflammation.


Presence of air between the pleura and the lung wall. The person usually feels difficulties to breathe and a pain that is intensified when inhaling (pulling the air), being able to radiate to the shoulders and near region.

Pulmonary disorders

Certain diseases that directly affect the lungs can cause pain when breathing, as in cases of pneumonia (infection of the lungs), pulmonary embolism ( pulmonary arteries blocked by clots) and pulmonary hypertension ( high pressure in the arteries of the lungs).

Lung cancer

Continuous pain that can be felt in the chest and back. Along with chest pain, it presents the following symptoms: fingers in the form of a stick (with swollen tips), hemoptysis (elimination of blood from the respiratory tract), dyspnoea, cough, among others.

Anxiety, panic attack and stress

Anxiety attacks, panic attacks and high doses of stress can cause chest pain, malaise, dizziness, restlessness and difficulty breathing. This type of pain is described as a tightness in the chest and can be mistaken for a heart attack.

What can be pain in the middle of the chest and burning?

Pain in the middle of the chest may occur with other symptoms. When the person feels pain and also burning, the cause may be a problem related to the digestive system or excess gas. See how these pains can be related to these conditions and when to seek medical help:

Non-digestive system problems

Pain caused after long periods without eating, gastritis, esophagitis , gastroesophageal reflux or gastric ulcer can be the source of chest pain. 

Esophageal spasms can also occur when a digestive problem causes the esophagus to expand and contract, which aggravates or intensifies the pain in the middle of the chest.


Excessive gas can cause sharp and intense pain, which seems to be located in the chest, usually in the central region. The person is not always able to notice the presence of gases quickly, which makes it appear that chest pain is the only symptom.

This is because flatulence causes bloating and swelling of the intestine. When the gases move, the discomfort can be even greater.

Read more: Excess gas: what can it be?

What are the risk groups for chest pain (chest pain)?

Patients over 40 or with a medical history of risk, such as a tendency to have high blood pressure, diabetes , angina, high cholesterol and obesity , should be monitored frequently, to ensure that chest pains are not serious problems.

Other groups that are at risk of contracting a disease that causes chest pain:

  • People with chronic renal failure;
  • Smokers;
  • Who has a family history of ischemic heart disease and patients with previous cases of the disease;
  • Sedentary people who maintain a diet rich in saturated fats;
  • Who makes use of drugs, like cocaine.

Chest pain: when can it be severe?

The causes of chest pain, whether on the left, right or center, can be quite variable. They do not always represent risks, although many people immediately associate them with cardiac conditions.

In general, any pain or malaise that persists for a few days, causes major discomfort, limits activities or worsens as the days go by must be investigated.

However, an emergency case usually involves manifestations such as:

  • If the chest pain takes more than 20 minutes to relieve, especially if it is associated with other symptoms;
  • If the pain gets worse with postural changes;
  • If the pain spreads to other places.

If the affected person has a cardiovascular disease , they should take the medication prescribed by the cardiologist correctly and go to the hospital if the pain does not pass within 30 minutes.

Chest pain of cardiac origin

Pain caused by heart disease is generally described as tightness, pressure or heaviness in the chest. It can radiate to other nearby areas, such as the back, neck, jaw, shoulders and arms (especially the left).

In addition, it tends to become more intense with physical exercise or when the person makes efforts.

The pain can stop and come back in minutes and other symptoms associated with chest pain of cardiac origin can appear:

  • Cold or excessive sweat;
  • Dizziness or weakness;
  • Nausea or vomiting;
  • Headache;
  • Lack of air;
  • Tachycardia.

Chest pain of non-cardiac origin

Pains caused by non-cardiac conditions still need treatment, but are not as urgent.

In general, they are located on the spot (right side, center of the chest) and do not spread to other areas. Depending on the cause, it is common for the intensity to worsen only when the chest makes some movement, when breathing deeply or squeezing the painful area.

There are numerous causes of non-cardiac pain. Therefore, it is important to note other associated symptoms that may indicate the cause or origin of the symptoms. Between them:

  • Sour taste in the mouth or nausea;
  • Difficulty swallowing;
  • Heartburn symptoms, such as painful and burning sensation behind the sternum bone.

How is the pain of a heart attack?

Infarction pain can be identified by the following characteristics:

  • Pain that doesn’t get better and doesn’t get worse with movements;
  • Reminds burning or burning;
  • It radiates to the left arm, jaw, head or back;
  • Persists for more than 10 minutes.

In cases of acute myocardial infarction, it is still possible for the person to have difficulty breathing, shortness of breath, irregular pulse, stomach pain and cold sweat.

In such cases, it is always advisable to seek an emergency medical center.

How is the diagnosis of chest pain made?

The diagnosis can be made from the analysis of the person’s clinical history, in addition to exams for a series of conditions. The symptoms and associated complaints are important for the correct driving to be done, and it may be indicated to seek specialists or perform other more specific tests.

To eliminate the possibility of heart disease or to distinguish between them, the health professional may order tests, such as:


The Electrocardiogram is a non-invasive and painless test, used to make an electrical assessment of cardiac activity. It serves to identify possible changes in the heart rhythm and the number of beats per minute, being able to discover disturbances in the cardiac electrical conduction.

It is an examination that is usually part of the initial investigations of chest pain.

Exercise testing

The exercise stress test, or stress test, is an evaluation of the cardiovascular functioning submitted to physical effort. It is usually done on a treadmill, but the intensity of the activity will depend on the condition of each patient.

The test looks at abnormalities in the amount of blood in the heart, heart rhythm disturbances and pumping capacity, as well as assessing the chances of angina and signs of heart attack.


Ultrasound exam that evaluates the heart cavities and the blood flow that passes through the heart valves. It is ideal for detecting dysfunctions or malformations of the heart.


The test is very popular, especially among those who suffer from gastric problems, such as gastritis. Despite being invasive, it is simple and without great risks.

Endoscopy can be suggested to people who suffer from chest pain if it is suspected to be related to problems with the digestive tract.

Reflux, digestion problems and gastritis can be the source of the pain.

Chest x-ray

When infections or changes in the respiratory tract are suspected, such as pneumonia and pneumothorax , imaging tests can be very important to analyze the structural state of the region.

This is because damage or obstruction can cause chest pain that intensifies when breathing.

Treatment: what to do to relieve chest pain?

Treatments for chest pain vary according to medical diagnosis and may consist of medication, non-invasive procedures, surgery or even need therapeutic intervention.

Among the most frequent treatments and advice are:

Stress relief

It is common for chest pains to be caused by emotional conditions or psychological disorders, especially stress and anxiety. In these cases, it is necessary that the framework is evaluated by professionals in psychology and psychiatry, who will guide you on the best treatment.

Psychological monitoring and the use of medications that alleviate anxiety attacks may be necessary.


When the pain is caused by infections in the respiratory tract, antibiotics may need to be used to help recover the condition. In addition, inhalation can be recommended as well, depending on each case.


If the chest pain is of muscular origin, caused by an injury or inflammation of the tissue, it is possible that in addition to analgesic and anti-inflammatory drugs, physical therapy is indicated.

The exercises, frequency and duration of treatment will be guided by professionals.

Pain Remedies

The use of analgesics and anti-inflammatory drugs may be indicated when the pain is due to trauma, injuries or efforts that caused injuries to some muscle or vertebra. In such cases, it is possible that the pain is radiated and appears to be occurring in the chest.

Physical exercises

The adoption of physical activities can help to improve conditions of chest pain that occur due to lack of conditioning. It is important that this is done with medical assistance and guidance from specialists in physical education, so that the entire clinical picture is evaluated.

With regular exercise, blood circulation is improved and the heart is more resilient. This gradually reduces that post-stress chest tightness.

Antacids and digestives

If the chest pain is caused by gastric disorders, the gastroenterologist may recommend the use of antacid medications, gastric aids or other treatments for disorders such as gastritis.

Food changes

If pain is associated with gas, a dietary change can help to relieve pain. Increasing fiber consumption, improving water intake, avoiding fermenting foods and adopting more balanced eating habits can make a big difference in intestinal health, reducing flatulence.

Surgical procedures for cardiac conditions

When the pain is severe and the cause is severe, related to cardiac changes, the treatment of chest pain may consist of surgical procedures, such as:


Little invasive surgical procedure, indicated to combat the obstruction of arteries that lead the blood flow to the heart, usually caused by accumulation of fat.

A balloon catheter is inserted into the femoral artery, through an incision in the groin, and guided to the blocked location. The balloon is inflated to expand and open the diameter of the artery. The stent, a tiny tube, can be inserted to keep the artery open.

Bypass surgery

Name given to myocardial revascularization surgery, the main technique for the treatment of coronary artery diseases, conditions that affect the arteries of the heart.

During the procedure, the surgeon uses the vein from another part of the body, usually the great saphenous vein (a leg vein), and creates an alternative route for the blood to bypass the blocked arteries. The operation is also indicated for patients suffering from ischemia, with risk of angina and infarction.

Repair of aortic dissection

In severe cases, chest pain can result from a fatal condition called aortic dissection, which consists of a rupture of the artery that carries blood from the heart to the rest of the body. Surgery should repair or replace the aorta as soon as possible.


Medicines for chest pain vary according to the diagnosis of each one. Consult a health professional to find out the cause of the pain and carry out the specific treatment for your condition.

For pain relief, professionals may prescribe certain medications. However, its use should not substitute for exams to diagnose the source of the problem. The drugs usually indicated are:

  • Dipyrone ;
  • Ares ( ipratropium bromide );

If the causes are related to the heart, professionals may recommend the following medications:

  • Aspirin ( acetylsalicylic acid );
  • Nitroglycerin , relaxes the arteries of the heart for blood to flow more easily.


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.


Complications of chest pain are quite variable and obviously depend on the cause of the problem.

Conditions that are related to heart problems have a higher risk of complications, which can result in infarction and death. However, most cases of chest pain are due to other conditions, such as stress and injuries.

Although they need treatment, these conditions tend not to have severe complications, as soon as the disease is slower and more gradual.

How to prevent chest pain?

There is no specific prevention, as chest pain can have several causes. However, some care and attitudes help to avoid pain, they are:

  • Avoid stress or anxiety situations;
  • Adopt a more relaxed lifestyle, with frequent physical exercise and a balanced diet;
  • Avoid cigarettes and drug use;
  • Reduce caffeine;
  • Stretch;
  • Keep exams and clinical appointments up to date.

Chest pain can be associated with non-fatal and easy-to-treat diseases, however, care should be taken when it becomes persistent or recurrent. To avoid further complications, this article seeks to inform about the causes of chest pain and the importance of paying attention to its symptoms.

Do you want to know more about the health of the heart and the whole organism? Keep an eye on the Healthy Minute!