What triggers chest pain? Understanding the causes

September 27, 2025 •

4 min read

According to the American Heart Association, chest pain is the second most common reason for emergency room visits in the U.S., with over 6.5 million visits annually. But while often associated with heart problems, a variety of conditions can explain what triggers chest pain, ranging from the benign to the life-threatening.

Quick Summary

Chest pain can be triggered by numerous factors, including heart conditions like angina and heart attack, respiratory issues like pneumonia and pulmonary embolism, and digestive problems such as GERD and gallstones. Musculoskeletal problems, like muscle strain or costochondritis, and psychological factors, such as panic attacks, can also cause chest pain.

Key Points

Heart conditions are common triggers: Angina and heart attacks are critical cardiac causes, characterized by pressure-like pain often triggered by exertion.
Non-cardiac triggers are frequent: Musculoskeletal issues like costochondritis and digestive problems such as GERD are common, causing a variety of pain sensations.
Anxiety can mimic serious conditions: Panic attacks can produce chest pain that feels very similar to a heart attack, accompanied by a rapid heart rate and shortness of breath.
Warning signs require immediate attention: Sudden, severe chest pain, especially with symptoms like shortness of breath, nausea, or pain radiating to the jaw or arm, warrants emergency medical help.
Differentiation is crucial: Paying attention to the specific characteristics of your chest pain—its location, duration, and associated triggers—can help medical professionals determine the underlying cause.
Never self-diagnose severe pain: Given the potential for life-threatening conditions, any unexplained or persistent chest pain should be evaluated by a healthcare professional.

Cardiac-related triggers

Chest pain related to the heart is often a major concern, and recognizing its specific triggers is critical. Angina is one of the most common heart-related causes, triggered when the heart muscle doesn't receive enough oxygen-rich blood, often during physical exertion or emotional stress. A heart attack occurs when blood flow to a part of the heart is completely blocked, leading to pain that is typically more severe and prolonged. Rarer but life-threatening conditions include aortic dissection, a tear in the body’s main artery that causes sudden, severe pain, and pericarditis, an inflammation of the sac around the heart.

Conditions affecting the heart muscle and function

Myocarditis: Inflammation of the heart muscle, often caused by a viral infection, can trigger chest pain along with fever, fatigue, and a rapid heartbeat.
Hypertrophic Cardiomyopathy: This genetic condition causes the heart muscle to thicken, making it harder for blood to flow. Chest pain and shortness of breath often occur during exercise.
Mitral Valve Prolapse: A heart valve that doesn't close properly can sometimes trigger chest discomfort and a rapid heartbeat.

Respiratory triggers

Beyond the heart, several lung conditions can explain what triggers chest pain, especially pain that worsens with breathing.

Pulmonary Embolism: This is a life-threatening emergency caused by a blood clot in the lung artery. The pain is often sharp and gets worse with deep breaths.
Pleurisy: Inflammation of the lining around the lungs causes sharp, stabbing pain when breathing deeply or coughing.
Pneumonia: A lung infection can trigger sharp chest pain, especially with a deep breath or cough, along with other symptoms like fever and chills.
Asthma: Inflammation of the airways can cause chest tightness, coughing, and wheezing.

Gastrointestinal triggers

Digestive system problems are a surprisingly common source of chest pain, often mimicking cardiac issues due to the proximity of the organs.

GERD (Gastroesophageal Reflux Disease): Acid reflux is a primary trigger for chest pain, causing a burning sensation, or heartburn, that can worsen when lying down or after meals.
Esophageal Spasms: Abnormal contractions in the food pipe can cause sudden, severe chest pain that is often mistaken for a heart attack.
Gallstones: Hardened deposits in the gallbladder can block the bile duct, causing intense upper abdominal pain that can radiate to the chest after a fatty meal.
Pancreatitis: Inflammation of the pancreas can cause severe pain in the upper abdomen that may radiate to the chest.

Musculoskeletal and psychological triggers

Sometimes, the cause of chest pain is unrelated to major organs and is instead rooted in the muscles, bones, or even mental state.

Costochondritis: This is an inflammation of the cartilage connecting the ribs to the breastbone. It can cause a sharp or aching pain that is tender to the touch and can be exacerbated by deep breathing or coughing.
Muscle Strain: Overexertion or coughing can strain the muscles between the ribs, leading to persistent chest pain that worsens with activity.
Anxiety and Panic Attacks: Intense fear can cause physical symptoms like a racing heart, shortness of breath, and chest pain, which can be difficult to distinguish from a heart attack.

Trigger comparison: Cardiac vs. Non-cardiac

It is often difficult to differentiate between cardiac and non-cardiac chest pain based on sensation alone. The table below outlines some general characteristics, but it is vital to consult a healthcare professional for an accurate diagnosis, especially with new or severe pain.


Feature	Cardiac (e.g., Angina)	Non-Cardiac (e.g., GERD, Muscle Strain)
Onset	Often brought on by physical exertion or emotional stress.	Can occur at any time, sometimes after eating or with specific movements.
Sensation	Pressure, tightness, squeezing, or heaviness.	Sharp, stabbing, burning, or aching sensation.
Location	Typically in the center or left side, may radiate to jaw, neck, arm, or back.	Pain can be localized or widespread, may be tender to the touch.
Duration	Lasts a few minutes, usually subsides with rest.	Can vary greatly, from seconds to hours; may worsen with breathing or movement.
Associated Symptoms	Shortness of breath, cold sweats, nausea.	Cough, fever, sore throat, or psychological symptoms like panic.
Relief	Often relieved by rest or specific medication (e.g., nitroglycerin).	May be relieved by antacids, pain relievers, or rest.

Seeking medical advice

Because the causes of chest pain are so varied and can include life-threatening conditions, it is always recommended to seek medical attention for unexplained chest pain. Pay close attention to the nature of the pain and any accompanying symptoms to help your doctor with the diagnosis. Do not hesitate to call 911 if you suspect a heart attack. For more detailed information on heart conditions, you can visit the American Heart Association website.

Conclusion

Understanding what triggers chest pain is crucial for recognizing when to seek help. While conditions like anxiety or GERD are common culprits, serious heart and lung issues must be ruled out. The key is to never ignore persistent or worsening chest pain. By paying close attention to your body's signals and seeking professional medical evaluation, you can get to the root of the problem and ensure appropriate treatment.

Frequently Asked Questions

Chest pain described as a crushing pressure is a classic sign of a heart condition like angina or a heart attack. If this pain is new, severe, or accompanied by other symptoms like shortness of breath or arm pain, seek emergency medical care immediately.

Yes, indigestion, particularly gastroesophageal reflux disease (GERD), is a very common trigger for chest pain. This pain, often called heartburn, is a burning sensation caused by stomach acid irritating the esophagus. It can often be worsened by lying down or after a large meal.

Chest pain that intensifies with deep breathing or coughing is often associated with respiratory issues. Conditions like pleurisy (inflammation of the lung lining), pneumonia, and pulmonary embolism can cause this type of sharp, stabbing pain.

It can be extremely difficult to distinguish between the two, as panic attacks can mimic heart attack symptoms very closely. With anxiety, the pain might be sharp or stabbing in the center of the chest, while a heart attack is more often a crushing or squeezing pressure. Given the ambiguity, it is always safest to seek immediate medical evaluation.

Yes, a muscle strain in the chest wall, often from heavy lifting, strenuous exercise, or even persistent coughing, can trigger persistent chest pain. This pain may feel sore or tender to the touch and typically worsens with movement of the upper body.

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 that can feel sharp or achy. The pain is usually tender when you press on the affected area.

Besides heart-related issues, non-cardiac triggers for chest pain in women include acid reflux, esophageal spasms, musculoskeletal pain, and anxiety or stress. Women may also experience different or more subtle heart attack symptoms than men, so any persistent or new chest pain should be evaluated by a doctor.