Can inflammation cause chest discomfort? A comprehensive guide

September 26, 2025 •

4 min read

According to research, many people who go to the emergency department for chest pain are ultimately diagnosed with a non-cardiac issue. It is important to know that yes, inflammation can cause chest discomfort, but it is critical to distinguish it from more serious heart-related problems.

Quick Summary

Inflammation is a definite cause of chest discomfort, stemming from conditions like pericarditis, pleurisy, and costochondritis, each affecting different structures in the chest; proper diagnosis relies on identifying specific symptoms and consulting a healthcare provider to differentiate it from cardiac issues.

Key Points

Inflammation is a cause: Yes, inflammation of tissues in and around the chest, including the heart's sac, lung lining, and rib cartilage, can directly cause chest discomfort.
Not always cardiac: Chest pain caused by inflammation (e.g., costochondritis, pericarditis) can mimic a heart attack, but it originates from non-cardiac structures.
Positional pain: A key feature of inflammatory chest pain is that it often changes with position or movement, such as worsening when lying down (pericarditis) or with deep breathing (pleurisy).
Distinguishing symptoms: Inflammatory pain may be accompanied by fever, cough, or fatigue, while classic heart attack symptoms include radiating pain, shortness of breath, and sweating.
Seek immediate care if needed: Always treat severe or uncertain chest pain as a medical emergency and seek immediate professional help to rule out life-threatening conditions like a heart attack.

Understanding the Link Between Inflammation and Chest Pain

Inflammation is the body's natural response to injury or infection, but when it affects tissues within the chest, it can lead to significant discomfort. The key to understanding this connection is recognizing that the chest contains many structures beyond the heart, including muscles, cartilage, the lining of the lungs (pleura), and the lining around the heart (pericardium). Inflammation in any of these areas can manifest as pain or pressure, mimicking more life-threatening conditions.

Common Inflammatory Causes of Chest Discomfort

Several conditions involving inflammation can cause chest discomfort. Differentiating between these and a cardiac event is crucial and often requires professional medical evaluation.

Costochondritis

What it is: Inflammation of the cartilage that connects a rib to the breastbone (sternum).
Symptoms: Sharp, aching, or pressure-like pain, often concentrated on the left side of the breastbone. It can radiate to the arms and shoulders and worsens with deep breaths, coughing, sneezing, or movement of the chest wall.
Key factors: Often caused by trauma, overuse from strenuous activity, or severe coughing.

Pericarditis

What it is: Inflammation of the pericardium, the thin, two-layered sac surrounding the heart.
Symptoms: Sharp, stabbing chest pain in the center or left side of the chest that may spread to the shoulder or back. The pain is often positional, worsening when lying down and improving when sitting up and leaning forward.
Key factors: Often follows a viral infection, but can also result from autoimmune diseases, heart attack, or injury.

Pleurisy

What it is: Inflammation of the pleura, the thin membranes lining the lungs and the inside of the chest wall.
Symptoms: Sharp, stabbing pain, usually on one side of the chest, that gets worse when you take a deep breath, cough, or sneeze.
Key factors: Usually caused by a viral or bacterial infection, autoimmune disorders, or a pulmonary embolism.

Systemic Inflammatory Conditions

Beyond localized issues, systemic inflammatory diseases can also cause chest discomfort by affecting tissues throughout the body. These include:

Rheumatoid Arthritis: An autoimmune disease that can cause inflammation in the joints, including those in the chest wall, leading to costochondritis-like pain.
Lupus: Can cause inflammation of the pleura (pleurisy) or pericardium (pericarditis), resulting in chest pain.
Ankylosing Spondylitis: This inflammatory arthritis can affect the spine and the joints where the ribs connect to the spine, causing chest stiffness and pain.
Fibromyalgia: A chronic pain syndrome that can cause widespread musculoskeletal pain, including the chest muscles, leading to tenderness and discomfort.

Diagnosis of Inflammatory Chest Discomfort

A doctor will typically perform a comprehensive evaluation to diagnose inflammatory chest pain. Since symptoms can overlap with cardiac issues, ruling out a heart-related problem is the first priority.

Medical History and Physical Exam: The doctor will ask about the nature of the pain, what triggers it, and other symptoms. They will listen to your heart and lungs with a stethoscope and may press on areas of your chest to check for localized tenderness, a key sign of musculoskeletal inflammation like costochondritis.
Imaging Tests: A chest X-ray can reveal signs of pneumonia, fluid buildup, or other lung-related issues. A chest CT scan or ultrasound may provide more detailed images of the chest structures.
Blood Tests: Blood tests can check for signs of infection or inflammation. In cases where a cardiac issue is suspected, they will test for cardiac enzymes.
Electrocardiogram (ECG or EKG): This test measures the electrical activity of the heart and is essential for ruling out a heart attack.

Comparison of Inflammatory Chest Pain Conditions


Feature	Costochondritis	Pericarditis	Pleurisy
Cause	Cartilage inflammation connecting ribs to sternum	Inflammation of heart's outer sac	Inflammation of lung linings
Pain Type	Sharp, aching, pressure-like	Sharp, stabbing	Sharp, stabbing, knife-like
Pain Location	Left side of breastbone, radiating to arms/shoulders	Center or left side of chest, radiating to shoulder/back	One side of chest
Worsened By	Deep breaths, coughing, movement	Lying down, deep breaths, coughing	Deep breaths, coughing, sneezing
Relieved By	Rest, medication, posture changes	Sitting up, leaning forward	Holding breath, pressing on area

Treatment and When to Seek Help

Treatment for inflammatory chest discomfort depends on the underlying cause. For musculoskeletal issues like costochondritis, rest and over-the-counter anti-inflammatory drugs (NSAIDs) often suffice. Infections causing pleurisy or pericarditis may require antibiotics, antivirals, or targeted anti-inflammatory medications.

It is crucial to be vigilant about any chest pain. While many cases are not life-threatening, it is always safest to assume the worst until a medical professional confirms otherwise.

When to seek immediate medical attention (call 911 or go to the ER):

Sudden, severe chest pain.
Chest pain that radiates to the jaw, left arm, or back.
Pain accompanied by shortness of breath, dizziness, nausea, or excessive sweating.
A feeling of crushing or squeezing under the breastbone.
Very rapid heartbeat or low blood pressure.

For more information on differentiating between chest pain types and other symptoms, resources like the American Heart Association offer valuable insights into heart health and warning signs.

Conclusion

While the prospect of chest pain is frightening, not all discomfort is a cardiac emergency. Inflammation is a significant and common cause, contributing to conditions such as costochondritis, pericarditis, and pleurisy. Recognizing the specific characteristics of inflammatory pain, like its positional nature or worsening with deep breaths, is important. However, it should never replace professional medical evaluation. The best approach is to take all chest pain seriously, consult a healthcare provider for an accurate diagnosis, and follow their recommended treatment plan to ensure proper care and peace of mind.

Frequently Asked Questions

Yes, inflammatory conditions like pericarditis and costochondritis can cause chest pain that is often mistaken for a heart attack. It is always best to seek immediate medical attention to ensure an accurate diagnosis and rule out a cardiac event.

Both conditions involve inflammation of the chest cartilage. The key difference is that Tietze syndrome typically involves swelling at the affected joints, which is not a feature of costochondritis.

Yes, systemic autoimmune diseases such as lupus, rheumatoid arthritis, and ankylosing spondylitis can cause inflammatory chest pain by affecting the pleura, pericardium, or rib joints.

Diagnosis typically involves a medical history review, a physical exam where the doctor may reproduce the pain by pressing on your chest, and diagnostic tests such as an EKG, chest X-ray, or blood tests to rule out cardiac or other serious issues.

Treatment varies depending on the specific cause. It can range from over-the-counter pain relievers and rest for conditions like costochondritis to prescription anti-inflammatory drugs or antibiotics for more severe cases like pericarditis or pleurisy.

Yes, many types of inflammatory chest pain, especially pleurisy and pericarditis, tend to worsen with deep breathing, coughing, or sneezing due to the movement of the inflamed tissues.

Yes, infections of the chest wall caused by bacteria or viruses can lead to inflammation and pain, including conditions like pleurisy. These are often diagnosed with imaging and blood tests.