Chest Pain: When to Seek Help

• Possible causes: Severe or stabbing chest pain is often associated with conditions such as pericarditis (inflammation of the sac surrounding the heart), pleurisy (inflammation of the lining of the lungs), or musculoskeletal problems such as muscle strains, rib injuries, and shingles.

• Distinctive features: This type of pain is usually localized to a specific area and may worsen with movement or breathing. If there is an accompanying rash along the painful area, the diagnosis may be shingles, a reactivation of the chickenpox virus.

• Possible causes: These feelings are often related to heart problems such as angina or a heart attack. Angina occurs when a blockage in the heart's blood vessels prevents the heart muscle from receiving enough blood. Acid reflux can also cause similar symptoms because the food pipe is located right behind the heart.

• Specific features: The pain may feel like someone is pressing or squeezing the chest and may radiate to the arms, shoulders, neck, jaw, or back. Angina is often worse with physical activity such as walking, climbing stairs, or running. Acid reflux is often closely related to food intake and lying position.

• Possible causes: A burning sensation in the chest can be a sign of acid reflux, also known as gastroesophageal reflux disease (GERD), when stomach acid flows back into the esophagus.

• Specific features: This type of pain is often accompanied by a sour taste in the mouth and can occur when eating or lying down.

• Possible causes: A dull, aching pain can be related to muscle strain, costochondritis (inflammation of the cartilage that connects the ribs to the breastbone), or even anxiety and stress.

• Specific features: The pain is usually mild to moderate and may last for long periods of time such as hours or days.

• Possible causes: Chest pain is another symptom commonly associated with heart problems such as angina or a heart attack. It can also be a sign of anxiety or panic attacks.

• Specific features: This feeling may come on suddenly and be accompanied by other symptoms such as shortness of breath, sweating, or dizziness.

• Possible causes: Aortic dissection (a tear in a major blood vessel in the chest), pulmonary embolism (a blood clot in the lung), or a heart attack (myocardial infarction) can cause sudden, severe chest pain. Musculoskeletal pain can also present as sudden, severe pain that usually subsides quickly and is not accompanied by other symptoms such as shortness of breath.

• Details: These conditions require immediate medical attention. The pain is often sudden and severe at first. It usually does not improve without treatment.

• Possible causes: Angina or gastroesophageal reflux disease (GERD) can cause intermittent pain. With angina, pain often occurs with exertion or stress and is relieved by rest. Pain associated with GERD can be affected by large meals or body position and can vary throughout the day.
  

• Details: It is important to consider the causes of intermittent pain to confirm the diagnosis.

• Possible causes: Conditions such as pericarditis (inflammation of the sac around the heart) and pleurisy (inflammation of the lining of the lungs) often cause pain that develops gradually.

• Details: The pain may increase in intensity over time and may be accompanied by other symptoms such as fever or cough. It is often associated with recent illnesses such as the flu. Sitting up straight and leaning forward tends to aggravate the discomfort of pericarditis.

• Possible causes: Chronic chest pain that lasts for weeks or months can be due to issues such as anxiety, musculoskeletal problems, or chronic gastrointestinal diseases.

• Details: This type of pain is usually less severe but persistent and can affect daily activities.
  

• Angina: Chest pain caused by reduced blood flow to the heart muscle, often caused by physical activity or stress.

• Heart attack (myocardial infarction): Occurs when blood flow to part of the heart is blocked, causing damage to the heart muscle.

• Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, causes sharp pain.
  

• Pulmonary embolism: A blood clot in the lungs causes sudden, severe chest pain, shortness of breath, and sometimes coughing up blood.

• Pleurisy: Inflammation of the pleura, the lining surrounding the lungs, causes a sharp pain that gets worse with breathing or coughing.

• Pneumonia : A lung infection that causes chest pain, fever, cough, and difficulty breathing.

• Gastroesophageal reflux disease (GERD): Acid from the stomach flows back into the esophagus, causing a burning sensation in the chest.

• Esophageal spasm: Sudden, severe spasms of the esophagus that can cause a heart attack. This condition is often caused by acid reflux.

• Peptic ulcer disease: Ulcers in the stomach lining can cause a burning pain in the chest.

• Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum, causing localized chest pain.

• Muscle strain: Overuse or injury to the chest muscles can lead to pain that gets worse with activity.

• Anxiety or Panic Attack: Intense fear or anxiety can cause chest pain accompanied by a rapid heartbeat, sweating, and shortness of breath. This pain is usually fleeting but can be very uncomfortable.

• Shingles (herpes zoster): A viral infection that causes a painful rash along a nerve pathway, which may include the chest area.

• Aortic dissection: A tear in the wall of the aorta, resulting in severe, tearing chest pain. This is a medical emergency.
  

To make it easier to understand, here is a chart showing the breakdown of possible causes of chest pain by age group.