Chest pain

Pain in the chest, which is often without serious cause, but which may be a symptom of an underlying disorder requiring urgent treatment. The pain may be in the chest wall or in an organ within the chest. The most common causes of pain in the chest wall are a strained muscle or an injury, such as a broken rib. A sharp pain that travels to the front of the chest may be due to pressure on a nerve root attached to the spinal cord as a result of, for example, osteoarthritis of the vertebrae. Pain in the side of the chest may be due to pleurodynia. The viral infection herpes zoster (shingles) may cause severe pain along the course of a nerve in the chest wall. In Tietze’s syndrome, inflammation at the junctions of the rib cartilages causes pain on the front of the chest wall. Pain within the chest may be caused by pleurisy, as a result of bronchitis, pneumonia, or, rarely, pulmonary embolism. Cancerous tumours of the lung (see lung cancer; mesothelioma) may cause pain as they grow and press on the pleura and ribs. Acid reflux may lead to heartburn, a burning pain behind the sternum. The common heart disorder angina pectoris causes pain in the centre of the chest that may spread outwards to the throat, jaw, or arms. Myocardial infarction (heart attack) and acute pericarditis both also produce severe pain in the centre of the chest. Mitral valve prolapse may cause sharp chest pain, usually on the left side. Chest pain may also be a result of anxiety and emotional stress (see hyperventilation; panic attack).