What are the three common causes of chest pain?

September 25, 2025 •

4 min read

According to Michigan Medicine, over 6.5 million people visit the emergency department annually for chest pain, with more than half of those cases having noncardiac causes. Given the wide range of possibilities, understanding what are the three common causes of chest pain can provide valuable context, though any serious symptoms warrant immediate medical evaluation.

Quick Summary

The three most common causes of chest pain are often gastroesophageal reflux disease (GERD), musculoskeletal issues like costochondritis, and heart-related conditions such as angina or a heart attack. While the specific sensation can vary, understanding the general symptom patterns can help determine when to seek medical help, emphasizing that a diagnosis must be made by a healthcare professional.

Key Points

Three Main Causes: The three common causes of chest pain are cardiovascular problems (e.g., heart attack, angina), gastrointestinal issues (e.g., GERD, esophageal spasm), and musculoskeletal problems (e.g., costochondritis, muscle strain).
Recognize Cardiac Symptoms: Heart-related chest pain often feels like a squeezing or pressure, possibly radiating to the arm or jaw, and can be accompanied by shortness of breath, nausea, or sweating. It's a medical emergency that requires immediate attention.
Identify GERD Pain: Digestive chest pain from GERD often feels like a burning sensation behind the breastbone, frequently triggered by meals or lying down, and can be relieved by antacids.
Spot Musculoskeletal Pain: Pain from musculoskeletal issues like costochondritis is typically sharp, localized to the chest wall or ribs, and worsens when you press on the area or with movement and breathing.
Know When to Seek Help: While many causes are non-life-threatening, you should always seek immediate emergency medical care for new, severe, or persistent chest pain, or if it's accompanied by other serious symptoms like difficulty breathing or dizziness. Never self-diagnose based on symptom pattern alone.
Professional Diagnosis is Key: The only way to get an accurate diagnosis for chest pain is through a medical evaluation by a healthcare professional, which may involve tests like an EKG or blood work.

Exploring the reasons behind chest pain

When experiencing chest pain, it's natural for many people to immediately fear the worst: a heart attack. However, it's important to know that chest pain can originate from various sources within the chest and even the abdomen. By understanding the common categories of chest pain, you can better communicate your symptoms to a healthcare provider. The three most frequently encountered culprits are cardiovascular problems, gastrointestinal disorders, and musculoskeletal issues. We will explore each of these in detail, but it is critical to seek immediate medical attention if you suspect a serious condition.

Cardiovascular causes: When to consider the heart

While not always the cause, cardiac-related issues are the most concerning and require prompt medical evaluation. The pain associated with heart conditions often results from the heart muscle not receiving enough oxygen-rich blood, a condition known as ischemia. Cardiac chest pain typically feels like a pressure, squeezing, or tightness rather than a sharp, localized stab.

Coronary Artery Disease (CAD) and Angina: Plaque buildup in the heart's arteries can restrict blood flow, leading to angina. Angina is chest pain or discomfort that occurs with physical exertion and subsides with rest. This is a crucial warning sign of underlying heart disease.
Heart Attack (Myocardial Infarction): A complete blockage of a coronary artery causes a heart attack. Symptoms often include intense chest pressure, shortness of breath, nausea, cold sweats, and pain radiating to the jaw, neck, back, or arms. Unlike angina, this pain does not resolve with rest and is a life-threatening emergency.

Gastrointestinal causes: Stomach and esophagus issues

Digestive problems are a surprisingly common source of noncardiac chest pain and are often mistaken for heart-related issues due to their proximity. The esophagus, which runs through the chest, can be the source of significant pain.

Gastroesophageal Reflux Disease (GERD): Often referred to as acid reflux or heartburn, GERD is caused by stomach acid flowing back into the esophagus. This can lead to a burning sensation behind the breastbone, especially after eating or when lying down. The pain can be severe and prolonged, mimicking cardiac pain.
Esophageal Spasms: These abnormal muscle contractions in the esophagus can cause sudden, intense chest pain that feels like a squeezing sensation. Unlike heart-related pain, esophageal spasms are often triggered by swallowing very hot or cold food or drinks and are not necessarily related to exercise.

Musculoskeletal causes: The chest wall and muscles

Pain originating from the muscles, cartilage, and bones of the chest wall is another frequent and typically less severe cause of chest pain. This type of pain is often reproducible by movement or direct pressure on the affected area.

Costochondritis: An inflammation of the cartilage that connects a rib to the breastbone. The pain is often sharp, can affect multiple ribs, and worsens with deep breaths, coughing, or when the area is pressed. Though benign, it can cause significant discomfort.
Muscle Strain: Vigorous exercise, heavy lifting, or a persistent cough can strain the intercostal muscles between the ribs or other chest muscles. This pain is often localized and may worsen with movement or coughing.

Comparison of common chest pain causes


Feature	Heart-Related Pain (e.g., Angina)	Gastrointestinal Pain (e.g., GERD)	Musculoskeletal Pain (e.g., Costochondritis)
Sensation	Pressure, squeezing, tightness, fullness	Burning, searing, or aching	Sharp, stabbing, or achy
Location	Central or left side of chest; can radiate to arm, jaw, back	Behind the breastbone, often rising from the abdomen	Localized to a specific spot on the chest wall or ribcage
Trigger	Physical exertion, emotional stress	After meals, especially large or fatty ones; lying down	Movement, coughing, specific arm or trunk movements, touching the area
Duration	Minutes, typically subsides with rest (angina); prolonged (heart attack)	Varies; can last minutes to hours	Varies; often lasts longer but can be intermittent
Accompanying Symptoms	Shortness of breath, nausea, sweating, dizziness	Sour taste, regurgitation, belching, swallowing difficulty	Tenderness to the touch, pain with deep breathing or coughing
Relief	Rest, nitroglycerin	Antacids, sitting upright	Anti-inflammatory medications, rest, ice/heat

When to seek emergency care

While distinguishing between the causes of chest pain is helpful, you should never self-diagnose. If you experience new, severe, or persistent chest pain, seek emergency medical help immediately. The symptoms of a heart attack can be varied and may present differently in women or older adults. When in doubt, it is always safer to err on the side of caution. An emergency room evaluation, including an EKG and blood tests, can quickly help rule out life-threatening conditions. For persistent but less urgent symptoms, a consultation with your primary care provider is the best course of action.

Conclusion: Prioritizing your health

Chest pain can be a frightening symptom, but understanding the three common underlying causes—cardiovascular issues, gastrointestinal problems, and musculoskeletal strain—can help you stay informed without causing unnecessary panic. Always prioritize medical evaluation, especially if the pain is severe, new, or accompanied by other concerning symptoms. By doing so, you can ensure a correct diagnosis and receive the appropriate treatment, whether for a benign condition or a serious medical event. For reliable health information, always consult with reputable sources such as the American Heart Association.

Frequently Asked Questions

Distinguishing between a heart attack and heartburn can be difficult. Heart attack pain often feels like pressure, squeezing, or fullness and may radiate to your arm, neck, or jaw. Heartburn, or GERD pain, is typically a burning sensation that can be triggered by eating or lying down. However, because the symptoms can overlap, it is always best to seek emergency medical attention immediately for any new or concerning chest pain.

Costochondritis is an inflammation of the cartilage that connects your ribs to your breastbone. It is a common, non-life-threatening cause of chest pain. The pain is often sharp or aching and can be reproduced by pressing on the affected area. It may worsen with deep breathing, coughing, or certain movements.

Yes, intense anxiety and panic attacks can cause chest pain. The sensation is often described as a tight pressure or pounding in the chest, accompanied by shortness of breath, rapid heart rate, and sweating. While not a heart attack, the symptoms are similar, and you should still seek medical evaluation to rule out serious cardiac issues, especially if you have never experienced them before.

You should go to the emergency room for chest pain if it is new, severe, persistent (lasting more than a few minutes), or if it is accompanied by other symptoms like shortness of breath, nausea, sweating, dizziness, or radiating pain to the arm, jaw, or back. When in doubt, always seek immediate medical help.

Musculoskeletal causes of chest pain include costochondritis (inflammation of rib cartilage), muscle strain from injury or heavy lifting, and rib fractures. This type of pain is often localized and can be reproduced or worsened by pressing on the affected area or with movement.

For GERD-related chest pain, you can try over-the-counter antacids to neutralize stomach acid. Lifestyle changes like avoiding trigger foods (spicy, fatty, acidic), eating smaller meals, and not lying down immediately after eating can also help. If the pain is persistent, a doctor may recommend stronger medication.

Yes, many other conditions can cause chest pain. These include lung problems like a pulmonary embolism (blood clot) or pneumonia, gallbladder issues, and aortic dissection (a serious tear in the aorta). This highlights why a professional medical evaluation is crucial for any unexplained chest pain.