Chest pain can be frightening, often leading people to worry about a heart attack. But all chest pain isn’t cardiac. In most cases, the pain is due to muscles, bones, cartilage or joints in the chest wall, referred to as musculoskeletal chest pain.

Depending on its cause, musculoskeletal chest pain may or may not be life-threatening but it can be difficult to differentiate from cardiac chest pain as both involve the same region of the body. Heart chest pain may be a serious medical emergency, so it is important to understand differences but remember that only a healthcare professional can make a diagnosis.

It is important to the patients at AB Heart Care not to overlook chest pain if it is unexpected. However, early evaluation may be helpful if there is a potential for a serious heart condition and/or reassuring if the condition is not cardiac.

What Is Musculoskeletal Chest Pain?

Musculoskeletal symptoms in the chest include pain that comes from the muscles, ribs, joints, cartilage or ligaments of the chest wall. It’s one of the most frequent non-cardiac causes of chest pain and frequently occurs after exercise, trauma, or poor posture, or as a result of inflammation.

Musculoskeletal pain is typically limited to a specific area and can shift when pressure is applied or the body moves.

Chest wall pain may be due to any of the following:

• Muscle strain when lifting heavy stuff
• Injuries resulting from physical exertion or sports events
• Prolonged sitting with poor posture
• Tightness of the chest muscles.
• Stiffness of the cartilage where the ribs meet the breastbone (costochondritis).
• Injuries to the ribs or fracture of ribs
• Repeat actions involving upper body.
• Persistent coughing
• P3 Arthropathy of the chest joints
• Fibromyalgia
• Muscle spasms

Patients are able to remember the activity that caused the pain in many cases.

What Is Cardiac Chest Pain?

Cardiac chest pain is the pain that comes from the heart muscle due to narrowed or blocked coronary arteries. This pain is often linked to either angina or a heart attack (myocardial infarction).

Chest pain that is related to the heart can be a life-threatening condition and therefore needs rapid evaluation.

People with unknown or recurring chest pain can visit the Best Cardiologist in Chandigarh to get an idea about what it may be.

Characteristics of Musculoskeletal Chest Pain

Musculoskeletal pain often has the following characteristics:

• Sharp or sore pain
• Pain that is confined to one area
• Worsening pain on pressing chest
• Getting worse when moving around the body.
• Backside or stomach pain when lifting heavy objects
• Change in breathing pattern or difficulty breathing deeply
• Rest and/or pain medication
• Symptoms that last many hours or days

The discomfort can be felt after strenuous activities and when you sleep in an unnatural position.

Characteristics of Cardiac Chest Pain

Chest pain associated with the heart typically is different. It is usually described by the patient as:

• Pressure
• Tightness
• Heaviness
• Squeezing sensation
• A fullness in the centre of the chest

This discomfort may not be well localized and may be hard to isolate with one finger.

If symptoms indicate a possible serious cardiac condition, evaluation with a Best Heart Surgeon in Chandigarh might be recommended based on the diagnosis and the need for treatment.

Musculoskeletal Chest Pain vs Cardiac Chest Pain

Feature	Musculoskeletal Pain	Cardiac Pain
Type of pain	Sharp, aching	Pressure, heaviness, squeezing
Exact location	Easily localized	Often central or widespread
Tender to touch	Usually yes	Usually no
Changes with movement	Frequently	Rarely
Worse with deep breathing	Often	Usually not
Trigger	Injury, exercise, posture	Physical exertion, emotional stress
Radiation	Usually absent	May spread to arm, jaw, neck, shoulder, or back
Duration	Hours or days	Minutes; may recur
Emergency risk	Usually low	Potentially life-threatening

Can You Reproduce the Pain by Touching Your Chest?

Pressure-induced tenderness over the area is one of the keys to diagnose musculoskeletal pain.

For example:

• Pain is reproduced by pressing on the ribs.
• The movement of the upper body increases pain.
• When you raise your arm, symptoms worsen.
• Pain is caused when muscles on chest are stretched.

Pressure applied to the chest does not (usually) reproduce the pain of the heart. Thus, tenderness should not rule out a cardiac etiology.

Warning Signs That Suggest a Heart Problem

If chest pain is accompanied by any of the following, get immediate medical attention:

• Shortness of breath
• Cold sweating
• A headache that develops in the eye region, spreading to the left side of the head
• Spread of pain into both arms
• Jaw or neck pain
• Upper back discomfort
• Nausea or vomiting
• Dizziness
• Fainting
• Sudden weakness

The symptoms are acute and need to be assessed.

What Is Costochondritis?

One of the most common etiology of Musculoskeletal chest pain is costochondritis. It is an inflammation of the cartilage that joins the ribs to the breastbone.

Typical symptoms include:

• Sharp pain near the sternum.
• Difficulty breathing
• Worse when coughing
• Higher level of pain during breathing in and out deeply
• Pain aggravated by certain body movements

While painful, costochondritis is not usually serious and can be treated conservatively.

Can Exercise Cause Chest Pain?

Yes, but there is a difference in the kind of pain.

Muscle pain from a new exercise or from heavy exercise typically comes from muscles or joints.

If the chest pain comes on during physical activity, particularly when it’s accompanied by shortness of breath or pressure, it may be the result of a diminished blood supply to the heart and should be checked right away by a trained cardiologist.

Can Stress Cause Chest Pain?

Yes, stress can cause chest pain

Muscle tension and chest discomfort may be caused by stress and anxiety. In addition to the above, some sufferers of panic attacks experience chest pain, palpitations, and breathlessness.

Regardless, a cardiac diagnosis should be ruled out, especially in patients who have cardiovascular risk factors, before the diagnosis of anxiety is considered.

Who Is More Likely to Have Cardiac Chest Pain?

The risk for heart disease rises with individuals who have:

• Diabetes
• High blood pressure
• High cholesterol
• Smoking history
• Obesity
• Sedentary lifestyle
• Chronic kidney disease
• History of heart disease in the family.
• Previous heart attack
• Being older than 45 years in men
• Old age (more than 55 years in females)

For these people, any kind of discomfort in the chest should be evaluated.

How Cardiologists Determine the Cause of Chest Pain

The evaluation process at AB Heart Care will start with a thorough medical history and physical exam. The cardiologist will suggest:

• Electrocardiogram (ECG)
• Echocardiography (2D Echo)
• Blood tests of cardiovascular enzymes
• Treadmill Stress Test (TMT)
• Holter monitoring
• CT Coronary Angiography
• Coronary Angiography (if necessary)

These investigations will help to decide if the chest pain is cardiac or non-cardiac and give information for treatment.

When Should You Visit the Emergency Room?

If you experience any of these symptoms, get emergency medical attention right away:

• Chest pain persists for over 10-15 minutes.
• The pain is like pressure or heaviness.
• Symptoms appear when someone is doing exercise.
• The pain radiates out to the arm, jaw, shoulder or back.
• It’s hard to breathe.
• You start perspiring to the point where you get cold sweats.
• Faint or feel very dizzy.
• It is not known what causes the chest pain.

The only way to be safe is to not assume the pain is muscular, it’s better to be safe than sorry when it comes to ruling out a heart attack.

Can Lifestyle Changes Help Prevent Both Types of Chest Pain?

 Numerous healthy lifestyles are protective for musculoskeletal health as well as for heart health:

• Maintain good posture.
• Perform exercise regularly and correctly.
• Do stretching exercises prior to heavy exercise.
• Keep a normal weight.
• Avoid smoking.
• Follow a heart-healthy eating plan.
• Control BP, diabetes and cholesterol.
• Get adequate sleep.
• Use relaxation strategies to lessen stress.

When Should You Consult a Cardiologist?

Schedule a consultation if you:

• Has repeated chest pain.
• Experience chest pain (while exercising).
• Have a family history of heart disease.
• Be diabetic or suffer from high blood pressure.
• Not sure if the pain is muscle or heart related.
• Be aware of worsening of symptoms or occurrence of symptoms more often.

Regular check-ups can detect heart disease in the early stages and avoid problems.

Frequently Asked Questions

Can muscle pain feel like a heart attack?

Yes. Sometimes muscle strain and inflammation of the chest wall can cause pain that is similar to heart pain. The best way to find out the cause is to have a medical evaluation.

Is chest pain that hurts when touched always muscular?

 Tenderness is usually a sign of a musculoskeletal source, but does not definitively exclude heart disease. If symptoms continue or if they are a concern, then check with a doctor.

Can lifting heavy objects cause chest pain?

 Yes. The muscles of the chest, ribs and cartilage can be stressed during heavy lifting and cause musculoskeletal chest pain.

Is cardiac chest pain always severe?

 No. In some cases, pressure, discomfort or tightness is only mild, particularly in older people, women and diabetes patients.

Should I visit a cardiologist even if I think it’s muscle pain?

Even if I believe it to be muscle pain, should I seek advice from a cardiologist?

If pain persists or comes back, or if it hurts, during exercise, or if heart disease risk factors are present, it is recommended to see a cardiologist to rule out heart disease.

Conclusion

Sometimes, the pain is due to the muscles in the chest wall and sometimes the pain comes from the heart. The causes, nature, and urgency of these two types of chest pain are quite different. Though muscle pain tends to shift when the person moves, or when pressure is put on the area, it usually isn’t life-threatening; cardiac chest pain can indicate poor circulation to the heart and shouldn’t be taken lightly.

If the pain is new, intense, frequent, or spreading to the arm, jaw or shortness of breath occurs, dizziness or sweating, call the doctor right away. If you have any recurring health issue or preventive heart checkup, AB Heart Care, with Dr. Ashwani Bansal at the helm, offers a complete cardiac assessment, advanced diagnostics and individualized treatment to help you safeguard your heart health.