Pain In The Middle Of The Chest: Is it Heart Attack?

Last updated on June 27th, 2018 at 07:31 am

Question: What causes pain in the middle of the chest? Is center chest pain due to a heart attack?

In the United States, about 630,000 deaths are attributed to heart disease: That is, about 25 percent of all deaths.

In fact, According to the heart disease fact sheet, a heart attack occurs every 40 seconds in the United States.

One common symptom of a heart attack is chest pain which is located at the center of the chest wall and radiating to the neck, shoulders and the back.

But don’t panic, if you are experiencing pain in the middle of the chest, its possible you have no heart attack, and it could be due to other conditions.

Anatomically, your chest (medically referred to as the thoracic cavity) is made up of different structure and organs. They include the esophagus, ribs, cartilage, sternum, heart and its blood vessels, and the lungs.

Any injury, inflammation or infections of these structures can cause chest pain. Sometimes, pain could be on the left side or right side, or in the center of the chest bone.

Having said that, it is essential you see your doctor to help examine and clarify the cause of your pain. Some question will be asked, and its best you are prepared for your clinic visit.

The duration of pain; It is important you remember when your pain started. Are you just experiencing pain for the first time or chest pain has continued to be present for a while?

The nature of your pain; Its also important you describe the kind of pain to your doctor. Is it sharp, dull, crushing, squeezing pain? Does it get worse during physical activity? Do pain disappear after taking a rest?

These questions (amongst others) are important to your doctor to determine the cause. This article explains reasons for middle chest pain and treatment options

What causes pain in the middle of the chest?

If you are experiencing chest pain in the middle of your chest bone, here are the possible causes

1.  Costochondritis

Costochondritis is the leading cause of central chest pain, especially in young adults. It accounts for about 30 percent of all chest pain in children. If you have center chest discomfort, its possible you have costochondritis.

In simple terms, costochondritis means pain in the junction of the ribs and the sternum, and mainly affects the upper bones (4th to 6th ribs).

Symptoms include middle chest pain that is sharp and aggravated when pressure is applied to the affected part of the chest wall.

Causes include viral infection, previous chest trauma or surgeries. However, in some patients, the pain will resolve on its own.

If you think your chest pain could be due to costochondritis, talk to your doctor. There are treatment options, at least to subside your pain. Options are the use of anti-inflammatory drugs and steroid injection (methylprednisolone).

2.  Direct chest trauma

If you’ve been involved in a direct injury to your chest, it could trigger a chest pain especially if there is a fracture of one or more of your rib bones.

Chest trauma can result from a fall, road traffic accident, or a fight. Inform your doctor for help.

3.  Heart attack or Angina

While a central pain could be due to costochondritis or direct chest trauma, its possible you already have a heart attack.

Medically, a heart attack means myocardial infarction which results from blockage of blood supply to parts of the heart muscle. If this occurs, you will experience a sharp, crushing or squeezing chest discomfort that may also be felt at your back, shoulders, neck, and jaws.

Usually, it is possible to identify early warning signs of a heart attack with difficulty in breathing, neck pain, arm pain and chest pain lasting for minutes. In some affected persons, chest pain may come and go.

It is important you quickly see your doctor for help as recovery is dependent on how fast you can get medical care. Initial treatment is centered on manual chest compression or the use of defibrillators.

Who are at risk of a heart attack?

There are risk factors that increase your likelihood of having a heart attack. They are obesity, hypertension, smoking cigarettes, diabetes, high body cholesterol level and poor diet.

Is chest pain the only symptom of a heart attack?

While chest pain is common in patients having a heart attack, you may also experience other symptoms which include vomiting, body weakness and fatigue, cough, restlessness, and feeling like throwing up.

Inform your doctor if you have these symptoms, its an emergency.

4.  Gastroesophageal reflux disease (GERD)

Within your chest wall is a long vertical tube called the esophagus that connects your mouth to your stomach. At the lower end of the esophagus is a valve or sphincter that regulates the movement of food from the esophagus to the stomach.

After eating, the lower sphincter relaxes and allows food to pass into the stomach, and then closes to prevent regurgitation of food.

In patients with gastroesophageal reflux disease, the lower esophageal splinter malfunctions allowing food already mixed with stomach acid to move into the esophagus, irritating the inner walls.

This can cause a burning sensation in the lower part of the central chest that could get worse at night. Other symptoms of a GERD are throat pain, difficulty in swallowing, cough, poor sleep, and food regurgitation.

Who is likely to have a GERD?

GERD is more common in men and women that are obese, smoking, scleroderma, and in pregnant women.

Also, eating late into the night cough cause reflux after sleeping. Other causes include alcohol consumptions and drugs like aspirin.

Is there treatment for GERD?

If you are experiencing a burning pain in the middle of your chest after eating that gets worse on lying down, it could be reflux.

First of all, lifestyle changes will help with your symptoms; They are

• Avoid alcohol consumptions, especially at night
• Stop smoking cigarettes
• Avoid eating late at night; And if you must do, don’t lie down immediately after taking your meal
• Try to keep a healthy weight
•  Avoid stressful conditions/work
• If symptoms persist, try elevating your head will a pillow while you sleep.

If these lifestyle changes fail to make you feel better, then you need to see your doctor. Treatment options involve the use of medications or antacids. In rare cases, surgery may be required.

5.  You probably have a peptic ulcer

Another reason for central chest pain is a peptic ulcer disease.

Peptic ulcer disease means the lining covering your stomach and small intestine (upper part/duodenum) has been eroded resulting in injury and upper abdominal pain (at the epigastrium). This happens for many reasons, and a bacterium called Helicobacter pylori has been implicated.

Other causes of peptic ulcer disease are overuse of painkillers, smoking, alcohol, and long-term stress.

Peptic ulcers symptoms include burning chest pain that is uncomfortable (sometimes felt at the back), belching, vomiting, and nausea. Also, in severe cases, the injury can bleed into the gastrointestinal tract resulting in vomiting of blood or passage of dark or black stool.

Other symptoms are tiredness, weight loss, and difficulty in breathing. In rare cases, the intestine can split open will passage of gastrointestinal contents to the abdomen resulting in peritonitis (fever, abdominal pain, vomiting).

While middle chest pain due to peptic ulcer can be discomforting, symptoms can be relieved by lifestyle changes, antacids, and taking a combination of antibiotics for two weeks.

Center chest pain: Other Causes

Apart from the above-listed causes, its important you know you chest discomfort may be due to other pathologies.

Other probable causes of chest pain are lobar pneumonia, muscle injury, chronic obstructive pulmonary disease, Asthma, Pulmonary hypertension/Embolism and bone disorders like osteomyelitis.

While is possible your chest pain could be mild and not life-threatening, you must see your doctor immediately if you have any of these symptoms.

• A sudden onset crushing and unbearable pain in your chest for minutes that radiates to your neck and arms
• Fast breathing that won’t go away with sweating, fatigue, and dizziness

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