Pain on the Right Side of the Chest? Here Are Some Possible Causes
THERE CAN BE MANY possible causes for pain on the right side of the chest. In fact, it's one of the most common reasons people visit the emergency room, says Dr. Stephen Keithahn, an internist at the University of Missouri in Columbia, Missouri.
When doctors try to pinpoint the cause of pain on the right side of the chest, they consider what's located in that part of the body. This includes:
- Skin.
- Muscles.
- Ribs.
- Cartilage, a type of connective tissue.
- Pleura, which is a thin lining around the ribs and chest cavity.
- The lungs.
- The diaphragm.
- In women, the right breast.
However, pain can radiate from another part of the body to the right side of the chest. For instance, you may have an injury in the neck or shoulders, but the pain can also be felt on the right side of your chest, says Dr. Mary Ann Bauman, a Seattle-based internist and a spokeswoman for the American Heart Association.
[ SEE: Questions to Ask a Pain Management Doctor. ]
Although the heart usually is located on the left side of the body, in some people it is shifted toward the right, says Dr. Pilar Stevens-Haynes, a cardiologist and director of echocardiography at Mount Sinai South Nassau in Oceanside, New York. This is why heart attack symptoms also can occur on the right side of the chest, not just the left side.
Not every cause of pain on the right side of the chest is serious, but some of them are. Any time you have pain on the right side of your chest, you should let your doctor know. You should seek emergency care for right-sided chest pain if you:
- Are coughing.
- Feel like you are going to pass out.
- Have a much faster or slower heart rate than usual.
- Have pain that comes on suddenly and sharply and isn't going away or you have pain that is radiating to the jaw and arms.
- Already have a respiratory illness.
- Have a fever.
- Have shortness of breath.
It's important to rule out more serious causes of pain before assuming the pain has a less serious cause, says Dr. Linda Anegawa, an internist with the telehealth platform PlushCare.
Possible causes for pain on the right side of the chest include:
- Anxiety attack.
- Collapsed lung.
- Costochondritis.
- Gallbladder problems.
- Gastroesophageal reflux.
- Heart attack.
- Lung cancer.
- Musculoskeletal strain or injury.
- Pericarditis.
- Pleuritis.
- Pneumonia.
- Pulmonary embolism.
- Rib fracture.
- Shingles.
Anxiety Attack
An anxiety attack is caused by an overwhelming feeling of stress or worry. Some of the symptoms of an anxiety attack include:
An increased heart rate. You may think you are having a heart attack, says Dr. Sunitha D. Posina, a board-certified internist and locum hospitalist in New York City.
- Feeling very worried or fearful.
- Shortness of breath.
- Nausea or a stomachache.
Anxiety attacks usually last 10 to 30 minutes. If you're not sure if you are having an anxiety attack, see a doctor to rule out other physical causes.
Collapsed Lung
Just as the name implies, a collapsed lung refers to air that pushes on the lung, making it collapse. Another name for this is pneumothorax. It's not always clear what causes a collapsed lung, but it is sometimes attributed to an injury to the chest or damage caused by lung disease. Another symptom of a collapsed lung, in addition to right-side chest pain, is shortness of breath. You should go to an emergency room if you think you have a collapsed lung, particularly if the pain is bad and if you have a lot of trouble breathing.
Costochondroitis
Cartilage connects our ribs to the breastbone. Costochondroitis is an inflammation of the cartilage in that area of the body. Symptoms of costochondroitis include chest pain and pain that gets worse when you cough or take a deep breath.
If you're not sure what's causing your chest pain but suspect it's costochondroitis, see a doctor to rule out more serious causes, such as a heart attack. Costochondroitis is seen in a third to half of patients who come to the ER with chest pain, Anegawa says.
Gallbladder Problems
Your gallbladder is located in the upper right corner of your abdomen. It stores a substance called bile, which helps your body break down fatty foods. Sometimes, pain on the right side of your chest radiates from the gallbladder.
There are several gallbladder problems associated with pain on the right side of your body, including an infection, gallstones or inflammation of a bile duct, which is one of the tubes that is part of your gallbladder and transports bile in your body.
Other symptoms associated with gallstone problems include:
- Chills.
- A fever.
- Nausea.
- Vomiting.
- Lighter-colored stools.
You should seek immediate medical attention if you suspect you have one of these gallstone-related issues.
GERD
GERD, which is short for gastroesophageal reflux disease, is also called acid reflux. It's caused by acid that comes from the stomach up to the esophagus. GERD is a common cause of pain on the right side of your chest. Other symptoms of GERD include:
- A bitter taste in your mouth.
- A chronic cough not connected to a respiratory illness.
Although GERD isn't serious, it can be uncomfortable. If you think you are experiencing GERD, try over-the-counter medicines such as antacids to help. If GERD's symptoms continue to bother you a couple of times each week, set a non-urgent appointment with your doctor.
Heart Attack
Although most people's hearts are located toward the left side of their body, right-side chest pain still can be associated with a heart attack. Other symptoms of a heart attack include:
- Dizziness.
- Nausea.
- Shortness of breath.
- Pressure or pain felt in the arms, jaw, neck or back.
The symptoms of a heart attack can be a little different for each patient. They also can be different in men versus women, Posina says. For instance, women may not feel the same pressure-like pain that men feel.
Call 911 if you think you are having a heart attack. "Don't assume if pain is on the right side that it can't be cardiac pain," Bauman cautions.
Lung Cancer
Depending on the location of the tumor or tumors caused by lung cancer, a person can have pain on the right side of the chest. Other symptoms associated with lung cancer include:
- An unexplained cough.
- Feeling more tired.
- Weight loss for no apparent reason.
Set an appointment with your doctor if you have these symptoms. Lung cancer that is in earlier stages is associated with better outcomes.
Musculoskeletal Strain or Injury
You can cause an injury to your chest area after a heavy cough or after strenuous activity such as exercise, Stevens-Haynes says.
If this type of injury occurs and you have pain on the ride side of the chest, let your doctor know. However, if you otherwise feel OK, it doesn't need to be an urgent appointment. Your doctor may recommend over-the-counter pain relievers or heat/ice therapy.
Pericarditis
There are two layers of tissue called the pericardium that surround the heart and help to hold it in place. When there's an inflammation of this tissue, it's called pericarditis. Chest pain is a common symptom of pericarditis. The pain can feel like the pain from a heart attack. However, the pain also can be caused by a heart attack. It also can be caused by an infection, injury or heart surgery. Because you may not know the exact cause, seek immediate medical attention if you suspect pericarditis.
Pleuritis
On the outside of the lungs and inside your chest cavity there's a thin membrane called the pleura. Pleuritis or pleurisy is the name for an inflammation in the pleura. Usually, there is fluid that coats the layers of the pleura. If you have pleuritis, the layers rub against one another and cause pain. It also can cause shortness of breath and a cough.
The cause of pleuritis isn't always clear, although an infection is one possible culprit. See your doctor if you think you might have pleuritis.
Pneumonia
Pneumonia is an infection in one or both of your lungs. Symptoms of pneumonia, in addition to pain on the right side or both sides of the chest, include:
- Pain that is worse when you cough.
- Coughing.
- A fever.
- Feeling more fatigued.
Pneumonia can be especially serious in those who are over age 65 and who have heart problems or chronic lung disease. See a doctor promptly if you think you have pneumonia.
A pulmonary embolism is a block that occurs in one of the lung's pulmonary arteries. Most pulmonary embolisms are caused by a blood clot that starts in the leg and moves to the lungs. Symptoms associated with a pulmonary embolism include:
- Dizziness.
- A fever.
- An irregular heartbeat.
A pulmonary embolism can be life-threatening, so seek immediate medical attention.
Rib Fracture
A rib fracture often is caused by an injury to the ribs. The pain from a rib fracture on the right side of the chest may get worse when you cough, laugh or sneeze. You also may have swelling or bruising near where the break occurred.
Seek immediate medical attention if you think you have a rib fracture. If you had an accident or injury, there could be other internal organ damage that requires treatment, Posina says.
Shingles
Shingles is caused by a virus called varicella-zoster. That virus is also the cause of chickenpox. Once you have chickenpox, that virus stays in your body. However, late in life, it can reactivate in your body as shingles.
Shingles often causes a painful rash or blisters on the left or right side of your torso. If it's on the right side of your body, it can cause pain on the right side of your chest. The pain from the virus is a type of nerve pain.
If you notice a rash or blisters along with right-side chest pain, call your doctor promptly, Bauman advises. There are anti-viral treatments for shingles, but they need to be started early. There also is a shingles vaccine for those age 50 or over to help prevent a shingles attack.