What would cause a pain in the middle of my chest? A comprehensive guide

September 25, 2025 •

4 min read

According to the Centers for Disease Control and Prevention, millions of emergency room visits each year are for chest pain, a symptom with many potential causes. Knowing what would cause a pain in the middle of my chest is vital for determining the right course of action, as the possibilities range from mild discomfort to serious emergencies.

Quick Summary

Pain in the middle of the chest has many potential origins, including cardiac issues like a heart attack, gastrointestinal problems such as acid reflux, musculoskeletal inflammation like costochondritis, and psychological factors like panic attacks. Distinguishing between these causes requires careful symptom evaluation and often professional medical diagnosis to rule out serious conditions. You should never ignore persistent or severe chest pain.

Key Points

Not always a heart attack: While heart-related causes are serious, pain in the middle of the chest is often caused by less severe issues like acid reflux or muscle strain.
Emergency symptoms: Seek immediate medical help for crushing chest pain accompanied by shortness of breath, nausea, sweating, or pain radiating to the arms or jaw.
Gastrointestinal issues mimic heart pain: Conditions like GERD and esophageal spasms can feel very similar to a heart attack, emphasizing the need for a professional diagnosis.
Musculoskeletal pain is common: Inflammation of the chest cartilage (costochondritis) or a simple muscle strain are frequent causes of localized chest wall pain.
Emotional distress can be a factor: Severe anxiety and panic attacks can induce chest pain, a racing heart, and other physical symptoms that mimic a medical emergency.
Distinguishing features matter: Pay attention to the type of pain (burning, sharp, pressure), its triggers (eating, movement, rest), and accompanying symptoms to provide valuable information to a doctor.

Potential Causes of Pain in the Middle of the Chest

Understanding the source of chest pain is a complex process because many organs and structures are located in this area. A thorough evaluation by a healthcare provider is essential, but understanding the possible origins can help guide your discussion with a doctor.

Cardiac-Related Causes

While not always the cause, heart-related issues are often the first concern for a pain in the middle of the chest due to the severity of these conditions.

Heart Attack

A heart attack occurs when blood flow to a part of the heart is blocked, most often by a blood clot. The pain is frequently described as a crushing pressure, tightness, or squeezing sensation in the center of the chest. It may spread to the arms (especially the left), back, neck, or jaw. Other symptoms include shortness of breath, cold sweats, nausea, and lightheadedness.

Angina

Angina is chest pain caused by reduced blood flow to the heart muscle. It is a symptom of coronary artery disease. Angina feels like squeezing, pressure, or fullness in the chest, and it often occurs with exertion and subsides with rest. The pain is similar to a heart attack, but it typically doesn't last as long and is predictable.

Pericarditis

This is the inflammation of the pericardium, the thin sac surrounding the heart. The pain associated with pericarditis is often sharp and stabbing, and it may feel better when you lean forward and worse when you lie down or breathe deeply.

Gastrointestinal Causes

Many digestive issues can cause pain that feels like it's coming from the middle of your chest, often mimicking heart-related problems.

Gastroesophageal Reflux Disease (GERD)

Commonly known as acid reflux or heartburn, GERD is caused by stomach acid flowing back into the esophagus. This can cause a burning sensation in the chest and may be accompanied by a sour taste in the mouth. It often worsens after meals or when lying down.

Esophageal Spasms

The esophagus is the tube that connects the throat to the stomach. Spasms in the muscles of the esophagus can cause sharp, crushing chest pain that can be easily mistaken for a heart attack.

Stomach Ulcers

An ulcer in the stomach lining can cause a gnawing or burning pain in the abdomen that can sometimes radiate up into the middle of the chest.

Musculoskeletal and Respiratory Causes

Pain can also arise from the chest wall itself or issues with the lungs.

Costochondritis

This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Costochondritis causes a sharp, aching, or pressure-like pain in the chest that often worsens with movement, deep breathing, or coughing. The pain can typically be replicated by pressing on the affected cartilage.

Muscle Strain

Overexertion from exercise, heavy lifting, or a severe bout of coughing can cause a strain in the chest muscles. The pain is usually localized to one area and can feel sore or sharp, especially when moving or stretching.

Pulmonary Embolism

This life-threatening condition is a blockage of an artery in the lungs, most often by a blood clot from the legs. It causes sharp, sudden chest pain that gets worse with deep breathing, as well as shortness of breath, rapid heart rate, and sometimes coughing up blood. This requires immediate emergency medical attention.

Pleurisy

Pleurisy is the inflammation of the tissue layers covering the lungs. It causes sharp chest pain that is typically worse with deep breathing, coughing, or sneezing.

Other Potential Causes

Sometimes, the cause of middle chest pain is neither cardiac nor digestive.

Panic Attacks

Anxiety and panic attacks can cause chest pain and other physical symptoms, including shortness of breath, a racing heart, sweating, and trembling. The pain is often sharp or stabbing, and the feeling of dread can make it difficult to determine the cause.

Shingles

This viral infection can cause a painful rash with blisters. If the shingles outbreak occurs on the torso, the pain and tingling may be felt in the chest area before the rash appears.

Comparing Common Causes of Middle Chest Pain


Symptom	Heart Attack	GERD (Heartburn)	Costochondritis	Panic Attack
Sensation	Crushing, squeezing pressure	Burning, sour taste	Sharp, aching, localized	Sharp, stabbing, or aching
Location	Mid-chest, may radiate	Behind breastbone	Side of breastbone/ribs	Mid-chest
Trigger	Often with exertion	After meals, lying down	Movement, deep breath	Stress, anxiety
Duration	Minutes, can return	30 minutes to a few hours	Days to weeks	Minutes, then subsides
Accompanying	Shortness of breath, nausea, cold sweats	Sour taste, burping	Tenderness when pressed	Racing heart, sweating, dread

When to Seek Immediate Medical Attention

While many causes of chest pain are not life-threatening, it is crucial to seek emergency medical care if the pain is new, severe, or accompanied by certain symptoms. Call 911 or your local emergency number immediately if you experience:

A sudden crushing, squeezing, or full feeling in the chest.
Pain that radiates to the jaw, neck, arm, or back.
Shortness of breath.
Nausea or vomiting.
Dizziness or fainting.
Cold sweats.
A rapid or irregular heartbeat.

Conclusion

Experiencing a pain in the middle of my chest is a common concern that can have a variety of causes. Because it is impossible to distinguish a serious heart condition from a less severe issue without medical evaluation, it is always wise to consult a healthcare professional. Understanding the different potential sources, from gastrointestinal to cardiac, can help you provide crucial details to your doctor and ensure you receive the proper diagnosis and treatment. For more information on cardiac health, please visit the American Heart Association website.

Disclaimer

This article is for informational purposes only and does not constitute medical advice. Please consult a qualified healthcare professional for diagnosis and treatment of any medical condition.

Frequently Asked Questions

You should go to the emergency room immediately if you experience crushing or squeezing chest pain, especially if it's accompanied by shortness of breath, pain radiating to the arm or jaw, cold sweats, or nausea. This is crucial for ruling out a heart attack.

Yes, panic attacks and high anxiety can cause chest pain. The body's stress response can lead to physical symptoms like rapid heart rate, shortness of breath, and chest muscle tension, which can feel like a cardiac event.

Gastroesophageal Reflux Disease (GERD), or acid reflux, is one of the most common non-cardiac causes of chest pain. It can cause a burning sensation behind the breastbone that can easily be mistaken for a heart problem.

Costochondritis is an inflammation of the chest cartilage that typically causes sharp, aching pain and tenderness when pressing on the area where your ribs meet the breastbone. The pain often worsens with deep breathing, coughing, or specific movements.

Distinguishing between digestive and cardiac pain is challenging without a medical professional. Digestive pain, like GERD, often feels like burning and is linked to eating or lying down. Cardiac pain is more likely to feel like pressure and is tied to exertion. When in doubt, always seek immediate medical evaluation.

Yes, stress can significantly impact your physical health and cause chest pain. Stress can lead to muscle tension in the chest wall, increase heart rate, and contribute to anxiety or panic attacks, all of which can manifest as central chest pain.

Even if chest pain subsides, it's important to consult a doctor, especially if it recurs. Conditions like angina or musculoskeletal problems can have intermittent symptoms. A professional evaluation can help identify the underlying cause and prevent future issues.