What causes tearing feeling in the chest?

September 23, 2025 •

5 min read

While many immediately associate chest pain with heart-related issues, a 2016 study found that a small percentage of emergency room visits for chest pain actually involve life-threatening cardiac problems. Understanding what causes tearing feeling in the chest is crucial, as this particular symptom can indicate a range of conditions, from benign muscle strains to medical emergencies requiring immediate attention.

Quick Summary

A tearing sensation in the chest can be caused by a variety of issues, from mild muscle strains and inflammation to life-threatening conditions like aortic dissection or esophageal rupture. Non-cardiac causes such as anxiety, acid reflux, or musculoskeletal problems are common, but distinguishing them from serious cardiac or pulmonary events is critical for patient safety.

Key Points

Seek Emergency Care: A sudden, severe, tearing chest pain that radiates to the back can be a sign of an aortic dissection, a life-threatening emergency requiring immediate medical attention.
Recognize Musculoskeletal Pain: A common, non-urgent cause is a chest muscle strain, often identified by localized tenderness and pain that worsens with movement or pressure.
Consider Non-Cardiac Issues: Many cases of chest pain are caused by non-cardiac problems like acid reflux (GERD), inflammation of the rib cartilage (costochondritis), or anxiety.
Understand Risk Factors: Individuals with high blood pressure, a history of heart issues, or those who have recently experienced trauma or strenuous activity may be at higher risk for certain causes of chest pain.
Avoid Self-Diagnosis: Because multiple conditions, both benign and life-threatening, can present with similar symptoms, it is unsafe to attempt self-diagnosis. A healthcare professional's assessment is critical.
Distinguish Symptoms: While a tearing sensation may be a hallmark of a serious condition, other accompanying symptoms like fever, shortness of breath, or sweating can also provide vital clues for diagnosis.

Understanding the Urgent vs. Non-Urgent Causes

It is important to differentiate between the potential causes of a tearing feeling in the chest. While some can be resolved with rest or simple treatment, others represent a medical emergency where immediate action is required. Symptoms accompanying the tearing sensation can provide critical clues, but a proper diagnosis from a healthcare professional is always necessary.

Life-Threatening Cardiac and Vascular Conditions

A tearing or ripping sensation is a hallmark symptom of some of the most serious conditions affecting the chest. Ignoring these signs can have fatal consequences.

Aortic Dissection

This is a rare but life-threatening condition where the inner layer of the body’s main artery, the aorta, tears. Blood then surges through the tear, causing the inner and middle layers of the aorta to split apart. This is a medical emergency requiring immediate surgery.

Key Symptom: Sudden, severe chest or upper back pain often described as a tearing or ripping sensation.
Associated Symptoms: May include shortness of breath, fainting, a weak pulse in one arm, and stroke-like symptoms.
Radiating Pain: The pain often radiates from the chest down the back between the shoulder blades.

Coronary Artery Dissection (SCAD)

Less common than aortic dissection, SCAD is a tear that develops in a coronary artery, blocking blood flow to the heart. It can occur spontaneously and is a cause of heart attack, particularly in younger individuals and women.

Key Symptom: Sudden, severe chest pain.
Associated Symptoms: Include shortness of breath, sweating, and pain that may radiate to the arm or jaw, similar to a typical heart attack.

Pulmonary Embolism

A blood clot that travels to the lungs can cause a sudden, sharp chest pain that may be described as tearing or stabbing. This is a life-threatening condition.

Key Symptom: Sharp chest pain that worsens with deep breathing or coughing.
Associated Symptoms: Include sudden shortness of breath, a rapid heart rate, and coughing, sometimes with bloody mucus.

Other Serious Non-Cardiac Emergencies

Not all emergency causes involve the heart and arteries. Some conditions affecting other organs in the chest can also cause a tearing sensation.

Esophageal Perforation (Boerhaave's syndrome)

A tear in the esophagus, the tube connecting the throat and stomach, is a medical emergency. It is often caused by forceful vomiting but can also result from medical procedures or injury.

Key Symptom: Sudden, severe, penetrating chest or neck pain that may feel tearing.
Associated Symptoms: Include fever, difficulty swallowing, shortness of breath, and vomiting blood.

Common and Less Severe Causes

While it is crucial to rule out emergencies, many instances of chest discomfort that feels like tearing are due to less severe but still uncomfortable issues. These often involve the muscles, bones, and other structures of the chest wall.

Musculoskeletal Issues

These are among the most common causes of chest wall pain and often feel worse with movement.

Pectoral Muscle Strain or Rupture: Overstretching or tearing a chest muscle, such as the pectoralis major, can cause a sudden, sharp, or tearing sensation. It often occurs during strenuous exercise, like weightlifting, or sudden, forceful movements.
Costochondritis: Inflammation of the cartilage connecting the ribs to the breastbone causes localized chest wall pain and tenderness. It can feel sharp or aching and may worsen with deep breathing, coughing, or certain movements.
Intercostal Muscle Strain: The small muscles between the ribs can be strained from excessive coughing, sneezing, or twisting, leading to a sharp or tearing pain that worsens with breathing.

Gastrointestinal Problems

Issues with the digestive system can often cause pain in the chest that mimics other conditions.

Gastroesophageal Reflux Disease (GERD): Acid reflux can cause a burning sensation, but sometimes the esophageal spasms can be felt as a tight, sharp, or tearing pain.
Esophagitis: Inflammation of the esophagus lining can lead to sharp chest pain, especially after eating or lying down.

Anxiety and Panic Attacks

Anxiety and panic attacks can produce a wide range of physical symptoms, including chest pain and tightness, which can be perceived as a tearing sensation.

Key Symptom: Chest pain often accompanied by rapid heart rate, shortness of breath, and a sense of impending doom.
Cause: The body's 'fight or flight' response releases stress hormones that increase heart rate and can cause muscle tension in the chest.

Tearing Chest Pain: Potential Causes Compared


Feature	Aortic Dissection	Musculoskeletal Strain	Esophageal Perforation
Onset	Sudden, excruciating	During or after exertion	Sudden, often after vomiting
Sensation	Ripping, tearing	Sharp or dull ache	Tearing, penetrating
Radiating Pain	Often to the back	Localized; worse with movement	Neck, upper abdomen
Associated Symptoms	Fainting, weak pulse	Swelling, bruising, tenderness	Fever, trouble swallowing
Urgency	IMMEDIATE EMERGENCY	Varies (often non-urgent)	IMMEDIATE EMERGENCY
Aggravated By	Often nothing; constant pain	Specific movements, deep breaths	Swallowing, deep breathing

What to Do When Experiencing a Tearing Feeling in the Chest

If you experience a sudden, severe, tearing chest pain, especially if it radiates to your back, jaw, or arm, or is accompanied by other symptoms like fainting or shortness of breath, you must seek emergency medical help immediately. Do not attempt to self-diagnose based on symptoms alone. Call 911 or your local emergency number.

For less severe symptoms that are not sudden or agonizing, it is still prudent to seek medical advice. Your primary care physician can perform an assessment to rule out serious conditions and help determine if the cause is musculoskeletal or related to another less urgent issue. Never assume a chest pain is harmless. The variability of symptoms across different conditions makes professional evaluation essential.

For general information on chest pain and when to seek medical help, the American Heart Association website provides guidance.

Conclusion

A tearing sensation in the chest is a symptom that should never be ignored. While its cause can be as simple as a strained muscle, it can also be the warning sign of a catastrophic medical event. Due to the overlap in symptoms between non-threatening conditions and critical emergencies like an aortic dissection, prompt medical evaluation is the safest and most responsible course of action. Accurate diagnosis from a healthcare professional is the only way to confirm the cause and ensure you receive the proper treatment, giving you peace of mind and potentially saving your life.

Frequently Asked Questions

You should go to the emergency room immediately if the tearing sensation is sudden, severe, or accompanied by other symptoms such as shortness of breath, fainting, a rapid heart rate, or pain that radiates to your back, jaw, or arm. These could be signs of a medical emergency like an aortic dissection or heart attack.

Yes, anxiety and panic attacks can cause chest pain and tightness, which some people may perceive as a tearing or sharp sensation. This is often caused by muscle tension and the body's 'fight or flight' response, but it is essential to have any new chest pain evaluated by a doctor to rule out other causes.

A muscle strain in the chest often causes localized pain that worsens when you move, breathe deeply, or press on the area. Heart-related pain, like angina or a heart attack, is more often described as a squeezing, tightness, or pressure, and may not change with movement. However, these symptoms can overlap, so medical evaluation is crucial.

Yes. A tearing or sharp chest pain that worsens with deep breathing or coughing could be related to a lung issue, such as a pulmonary embolism (blood clot in the lungs) or pleurisy (inflammation of the lung lining). Both require prompt medical attention.

Pain from acid reflux (GERD) is often described as a burning sensation, but it can also feel sharp or tight. It may be triggered by eating, particularly fatty or acidic foods, and might worsen when lying down. It can be difficult to differentiate from heart pain, making medical consultation necessary.

Mild musculoskeletal pain can often be managed with rest, ice packs, and over-the-counter pain relievers (like ibuprofen), as recommended by a doctor. However, no home remedy should be used for a sudden, severe, or unexplained tearing chest pain. Always seek medical advice first to ensure the cause is not life-threatening.

Costochondritis is the inflammation of the cartilage that joins your ribs to your breastbone. While it typically causes sharp or aching pain, the intense inflammation can sometimes be perceived as a pulling or tearing feeling, particularly with chest movement, deep breathing, or coughing.