Pain in Center of Chest: Causes and Treatments

Pain in the center of your chest can be due to a number of reasons. Sometimes it is easy to distinguish if the pain is not serious and possibly only due to muscle strain. Other times, it is more difficult to definitively diagnose the source of the pain without performing some tests and investigations. Depending on your medical history, you should consult your doctor if you experience any new chest pain, especially if you have cardiac or lung problems.

Possible Causes of Pain in Center of Chest

The common causes of chest pain are:

1. Angina

This type of pain is caused when the heart muscle does not receive a sufficient blood (oxygen) supply. The blood supply can be reduced or interrupted when the arteries feeding the heart have narrowed due to the build-up of plaques (fatty deposits in the arteries). Plaque formation builds up over time and can start in one or more places. The blood supply to the heart may be sufficient while you’re resting but increased activity will cause angina.

Symptoms: Angina pain can be described as an ache, tightness or discomfort in the front of your chest. The pain may also be referred pain and felt as far away as your jaw, neck, arms or stomach.

2. Heart Attack

This occurs when the blood supply to a portion of the heart muscle is suddenly interrupted and that affected area is at risk of being permanently damaged. The blockage is usually caused by a blood clot which forms when there is a plaque present in the artery. The blood flow is not smooth around the plaque, which causes the blood to clot. Prompt medical care and medication to break up the clot can prevent any permanent damage to the heart muscle. Symptoms of a heart attack are similar to angina but more severe and long-lasting. Chest pain, feeling an intense pressure in the chest, pain in the jaw, neck or arms, feeling faint, sweating and shortness of breath are the common symptoms.

3. Costochondritis

Inflammation of the joints between the ribs and cartilage or between the sternum and clavicles causes pain in center of chest.

Symptoms: The pain is sharp and stabbing. It is made worse with movement, deep breathing or exertion. The pain can be localized or sometimes diffuse over a larger area.

4. Gastro-Esophageal Reflux Disorder

This disorder includes acid reflux, which occurs when acid from the stomach refluxes into the esophagus; and esophagitis, which is the inflammation of the esophagus caused by the acid reflux. There is a band of muscle (sphincter) at the top of the stomach to prevent stomach contents from refluxing back into the esophagus. When this sphincter is not functioning as it should, stomach contents go upwards in the wrong direction.

Symptoms: The presence of acid in the esophagus causes chest pain, bloating, nausea and an acid taste in the mouth. These symptoms are often confused with those of a heart attack.

5. Anxiety

Feelings of anxiety may present as chest pain. This is especially true in people who have previously had a heart attack or had friends or relatives suffer from a heart attack. Accompanying symptoms are: increased breathing, raised heart rate, palpitations and shaking.

6. Chest Wall Muscle Strain

Activities such as heavy lifting, long bouts of coughing and stretching may cause the chest wall muscles to strain, leading to pain in the center of the chest. The pain is made worse by movement or breathing.

7. Pneumonia with Pleurisy

If the chest pain is accompanied by fever and cough producing bad-smelling sputum, it is likely that the person has pneumonia. Pleurisy is the inflammation of the membranes that surround and protect the lungs. This condition can cause chest pain when breathing or coughing.

Consult your doctor if you experience pain in center of chest to make a proper diagnosis because many people present differently with symptoms of a heart attack. Below is a table to help you check if your symptoms are related to cardiac problems. However, this shouldn't replace a medical diagnosis from your doctor.

Likely to Be a Heart Attack (Cardiac Chest Pain)

Less Likely to Be a Heart Attack (Other Chest Pain)

Sensation of squeezing, burning, tightness

Sharp pain made worse by breathing or coughing

Pain increases gradually

Pain is sudden

Pain felt in a general area of the chest

Pain localized to a specific area of the chest

Pain may be felt in jaw, arms, neck

Localized pain

Accompanied by nausea, sweating

No other symptoms

Pain occurs after physical exertion, stress or while resting.

Pain increases when pressure is applied to the area.

How to Manage Pain in Center of Chest

If you suspect you’re having a heart attack:

  • Call the emergency services.
  • If you’re not allergic, take some aspirin.
  • Avoid strenuous activity. Rest comfortably and try to remain calm.
  • Loosen any tight clothing and wait for the emergency services.

Chest pains from lung conditions:

  • Seek medical attention if accompanying symptoms are severe like coughing sputum, high fever, breathing difficulties.
  • The doctor may prescribe antibiotics to fight the infection.

Anxiety or panic attack:

  • Breathe in deeply and slowly to decrease your breathing rate and relax your chest muscles. This will also help to control your panic.
  • Schedule regular relaxation sessions like massage.
  • Panic attacks that occur regularly should be evaluated by a professional like a psychiatrist.

Pain in center of chest due to acid reflux:

  • Keep body upright by standing or sitting up. Avoid lying down which makes the burning sensation worse.
  • Take some antacids to relieve the symptoms. Read the instructions on the package before taking them.
  • If the heartburn occurs frequently, see your doctor about prescribing medicine to decrease your acid production.

Chest pains due to costochondritis:

  • Take pain medication that you can get over-the-counter.
  • Rest so that the muscles can heal.
  • Stretch adequately before doing any strenuous chest exercises.
  • Apply heat to ease the pain.
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