What is the cause of chest pain and arm pain?

September 30, 2025 •

5 min read

Chest pain accounts for over 6 million emergency department visits in the U.S. annually. The combination of chest pain and arm pain can be a sign of a serious medical emergency, such as a heart attack, but can also stem from less severe, non-cardiac issues, highlighting the importance of understanding the potential causes.

Quick Summary

Chest and arm pain can signal various conditions, including life-threatening heart attacks and less severe issues like muscle strain, nerve compression, and GERD.

Key Points

Heart Attack: A life-threatening emergency often involving crushing chest pain that radiates to the arm, jaw, or back, accompanied by shortness of breath and sweating.
Musculoskeletal Pain: A common non-cardiac cause of chest and arm pain, stemming from muscle strains, inflamed cartilage (costochondritis), or nerve compression (TOS).
Gastrointestinal Issues: Conditions like acid reflux and GERD can cause burning chest pain, which can be mistaken for heart-related pain, and can sometimes be felt in the arm.
Nerve Compression: A pinched nerve in the neck or upper spine can cause radiating pain, numbness, and tingling into the chest and arms.
Psychological Factors: Panic attacks and high anxiety can produce physical symptoms, including sharp chest and arm pain, that closely mimic a heart attack.
Immediate Medical Attention: Any sudden, severe chest pain radiating to the arm, especially with other symptoms like nausea or sweating, requires immediate emergency care.

The combination of chest and arm pain is often a significant concern due to its association with heart disease. While immediate medical attention is critical to rule out life-threatening conditions, it is also important to recognize that many other factors can cause these symptoms. Understanding the different potential causes can help individuals make informed decisions about seeking care. The diagnosis typically involves a careful review of symptoms, medical history, and a physical examination.

Cardiac Causes of Chest and Arm Pain

When someone asks, 'What is the cause of chest pain and arm pain?' the most urgent consideration is a cardiac event. The pain from a heart issue often radiates from the chest to other parts of the upper body, such as the arm, neck, and jaw, due to shared nerve pathways.

Heart Attack

A heart attack occurs when a coronary artery becomes blocked, cutting off oxygen-rich blood flow to the heart muscle. This causes permanent damage to the heart tissue. Symptoms can include:

Discomfort, pressure, fullness, or a squeezing sensation in the center or left side of the chest that lasts for more than a few minutes.
Pain or discomfort in one or both arms, the back, neck, or jaw.
Shortness of breath.
A cold sweat, nausea, or lightheadedness.

Angina

Angina is chest pain that results from the heart muscle not getting enough blood flow, often due to coronary artery disease. Unlike a heart attack, angina is usually a temporary condition. It is typically triggered by physical exertion or stress and subsides with rest.

Pericarditis and Myocarditis

Pericarditis is the inflammation of the sac surrounding the heart (the pericardium), while myocarditis is the inflammation of the heart muscle itself. Both conditions can cause sharp, stabbing chest pain that may radiate, often accompanied by other symptoms like fever and fatigue.

Aortic Dissection

This is a life-threatening emergency where the inner layer of the body's main artery, the aorta, tears. It causes sudden, severe chest pain that can radiate to the back and upper body, and requires immediate medical intervention.

Non-Cardiac Causes of Chest and Arm Pain

While it is crucial to address cardiac concerns first, non-cardiac issues are actually the most common cause of chest pain.

Musculoskeletal Issues

Pain in the muscles, bones, and cartilage of the chest wall can be mistaken for heart-related pain.

Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone. It can cause sharp or aching pain that is often worse with movement or deep breaths.
Muscle strain: Overexertion or injury can strain the pectoral or intercostal muscles, leading to localized pain.
Thoracic Outlet Syndrome (TOS): Compression of the nerves or blood vessels between the neck and chest, resulting in pain, numbness, and tingling in the arm and shoulder.

Gastrointestinal Conditions

Problems with the digestive system can often cause pain that is felt in the chest.

Acid Reflux (GERD): Stomach acid backing up into the esophagus can cause heartburn, a burning sensation in the chest that may sometimes radiate.
Esophageal Spasms: Abnormal muscle contractions in the esophagus can cause sudden, intense chest pain that mimics a heart attack.
Gallstones: Can cause referred pain in the chest, back, and right shoulder, often after a fatty meal.

Nerve-Related Issues

Pinched or irritated nerves can cause pain that radiates into the chest and arm.

Pinched nerve (radiculopathy): A compressed nerve in the neck or upper spine can send pain signals to the chest and arms, sometimes accompanied by tingling or numbness.
Shingles: A reactivation of the chickenpox virus, causing a painful, blistering rash that can affect nerves in the chest wall, leading to localized or radiating pain.

Respiratory Problems

Conditions affecting the lungs can also present with chest and arm pain.

Pulmonary Embolism: A blood clot in the lung artery that causes sudden, sharp chest pain and shortness of breath.
Pneumonia: A lung infection that can cause chest pain, especially with coughing or deep breaths.
Pleurisy: Inflammation of the lining of the lungs and chest cavity, causing sharp chest pain when breathing.

Psychological Factors

High anxiety or a panic attack can cause physical symptoms, including chest and arm pain.

Panic Attack: A sudden surge of intense fear that can trigger symptoms like chest pain, shortness of breath, rapid heart rate, and dizziness, mimicking a heart attack.

Differentiating Between Causes: A Comparison

To help identify the source of the pain, here is a comparison of common symptoms associated with different conditions:


Feature	Heart-Related (e.g., Heart Attack)	Musculoskeletal (e.g., Costochondritis)	Gastrointestinal (e.g., GERD)
Sensation	Crushing pressure, squeezing, or fullness.	Sharp, localized, aching pain.	Burning or indigestion-like sensation.
Radiating Pain	Spreads to arm, jaw, neck, or back.	Often localized, but can sometimes feel widespread.	Can radiate upward to the throat or neck.
Triggers	Exertion, emotional stress, or at rest.	Movement, coughing, or pressing on the area.	Eating, especially fatty or large meals; lying down.
Associated Symptoms	Shortness of breath, cold sweat, nausea.	Worsens with specific postures or pressure.	Belching, bloating, sour taste.
Duration	Lasts more than a few minutes or comes and goes.	Can be constant or intermittent, potentially lasting for days.	Episodic, often related to meals.

When to Seek Emergency Medical Help

While many causes of chest and arm pain are not life-threatening, it is always safer to assume the worst and seek prompt medical care, especially if the pain is new or unexplained. You should call 911 immediately if:

You experience sudden, crushing, squeezing, or tightening chest pain.
The pain spreads to your jaw, left arm, or between your shoulder blades.
You have other symptoms like nausea, dizziness, excessive sweating, or shortness of breath.
The chest discomfort is more intense or lasts longer than usual if you have a history of angina.
The pain begins at rest.

Conclusion

Chest and arm pain can arise from a wide range of causes, from life-threatening heart conditions to benign musculoskeletal issues. The most critical step is to differentiate between a medical emergency, such as a heart attack, and other possibilities. When in doubt, seeking emergency medical help is the safest course of action, particularly if symptoms are severe, sudden, or accompanied by classic cardiac warning signs. A healthcare professional can perform the necessary tests to determine the underlying cause and ensure appropriate treatment, putting your mind at ease and protecting your health.

Mayo Clinic guide on heart attack symptoms

Frequently Asked Questions

No, pain in the left arm is not always a heart attack, although it is a classic symptom. Other issues like muscle strain, nerve compression (Thoracic Outlet Syndrome), or a pinched nerve can also cause left arm pain, but any unexplained chest and arm pain warrants immediate medical evaluation.

Yes, a panic attack can cause physical symptoms that mimic a heart attack, including chest pain, a rapid heart rate, and pain or numbness in the arms. It is important to rule out heart conditions with a medical professional.

Pain from a muscle strain typically worsens with movement, coughing, or applying pressure to the affected area. Unlike heart-related pain, it does not involve symptoms like shortness of breath or dizziness and may feel more localized.

Yes, acid reflux (GERD) can cause chest pain that may radiate to other areas. Sometimes, the pain can be felt in the jaw or back, potentially including the arm, making it difficult to distinguish from cardiac issues.

You should seek emergency medical help immediately if you have sudden, severe, or crushing chest pain that radiates to your arm, jaw, or back, or if it is accompanied by shortness of breath, a cold sweat, or nausea.

Yes, while chest pain is the most common symptom for both, women are more likely to experience other symptoms like unusual fatigue, back or jaw pain, nausea, and shortness of breath. Women may also have less severe or less typical chest pain.

Yes, a pinched nerve (radiculopathy) in the cervical or thoracic spine can cause pain that radiates into the chest, shoulder, and arm. The pain may be sharp or tingling and can be worsened by certain movements.