People often talk of others as being a “pain in the neck” or some other ( impolite ) part of the anatomy, but never would you hear someone being described as a “pain in the chest”!

Chest pain is discomfort or pain felt anywhere along the front of your body between your neck and just above your belly button. The best way to understand what causes chest pain is to consider all the structures within that zone.

These are your heart and its coverings, your lungs and their coverings, the oesophagus and parts of your upper bowels, your ribs and breastbone, your blood vessels, muscles and nerves. Quite a list. Pain may also spread to the chest from the neck, abdomen, and back.

Most of the causes are not dangerous, some are serious and some can be life-threatening. The number one fear with chest pain is a heart attack.

Heart and blood vessel causes

Here there is a feeling of tightness, heavy pressure, squeezing, or crushing pain. The pain may spread to the arm, shoulder, jaw, or back. A tear in the wall of the aorta, the large blood vessel that takes blood from the heart to the rest of the body (aortic dissection) causes sudden, severe pain in the chest and upper back.

Swelling (inflammation) of the “bag” that holds the heart (pericarditis) causes pain in the center part of the chest.

Lungs related causes:

A blood clot in the lung (pulmonary embolism). The clot may travel all the way from the foot in situations of immobility ( as in bed-bound, or long haul flights) and other factors. Collapse of the lung (pneumothorax)

Pneumonia causes a sharp chest pain that often gets worse when you take a deep breath or cough.

Swelling of the lining around the lung (pleurisy) can cause chest pain that usually feels sharp, and often gets worse when you take a deep breath or cough.

Other causes of chest pain:

Inflammation where the ribs join the breast bone or sternum (costochondritis). This can follow trauma to the chest.“The chicken pox (shingles) virus, after its initial skin manifestation, can hide in the nerves of the body for decades, only to reappear and cause a severe debilitating neuropathic pain. It causes a sharp, tingling pain on one side that stretches from the chest to the back, and may cause a rash.

Strain of the muscles and tendons between the ribs

Stomach and gut causes:

Spasms or narrowing of the esophagus (the tube that carries food from the mouth to the stomach)

Gallstones cause pain that gets worse after a meal (most often a fatty meal).

Heartburn or gastroesophageal reflux Stomach ulcer or gastritis: Burning pain occurs if your stomach is empty and feels better when you eat food.

Call a doctor or get to a hospital as quickly as possible if you have any of these associated

Symptoms or circumstances:

Sudden, crushing, squeezing, tightening, or pressure in the chest. Pain spreads (radiates) to the jaw, left arm, or between the shoulder blades.

Nausea, dizziness, sweating, a racing heart, or shortness of breath. A usual angina and chest discomfort is suddenly more intense, brought on by lighter activity, lasts longer than usual or occurs at rest.

Sudden, sharp chest pain with shortness of breath, especially after a long trip, prolonged bedrest (eg after surgery), or other lack of movement, especially if one leg is swollen or more swollen than the other (this could be a blood clot, part of which has moved to the lungs).

You are already diagnosed with a serious condition, such as heart attack or pulmonary embolism.

It could be a heart attack if:

A pain in the chestThere’s a family history of heart disease You smoke, use cardio-stimulants, are overweight, have hypertension, high cholesterol, diabetes or you already have heart disease.

Fever or a cough that produces yellow-green phlegm, problems swallowing, or chest pain lasting longer than 5 days require a call or visit to a doctor.

After the Cardiologist has ruled out the more life threatening causes, the Pain Doctor will aim to fix the rest.

Pain, in wherever anatomy, is not a good thing.