What Chest Pain on Your Left Side Could Mean
Chest pain on the left side is concerning, but it may not always mean you're having a heart attack.
Does chest pain on the left side mean a heart attack?
Who hasn’t seen an actor on TV or in a movie fall to their knees clutching the left side of their chest, clearly in pain and in distress? The character was clearly having a heart attack, as far as we could tell.
Chest pain is one of the symptoms of a heart attack. But it doesn’t automatically mean you’re having one. It could be a symptom of a less serious condition such as heartburn or pain from excessive coughing when you have a chest infection.
Yet, even seemingly harmless conditions can feel like a heart attack. So how do you know if chest pain on the left side is something you should worry about?
We asked several cardiologists what chest pain on your left side could be.
Reasons why we have chest pain on the left
Since the heart shares space with other organs, tissues, and nerves, chest pain on the left side could be from a number of other things.
“Lung, bone, gallbladder, pancreas, stomach, and soft tissue conditions can result in chest pain or discomfort on the left side,” says cardiologist Noel Bairey Merz, MD, director of the Barbara Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai in Los Angeles.
Other times, chest pain could be a warning sign of something more critical, says Ankur Kalra, MD, an interventional cardiologist at the Cleveland Clinic, in Akron, Ohio. “Dull pain radiating to the jaw, neck, back, shoulder or arm; stabbing pain radiating to the back; constant, dull pain for several minutes.” None of these are a good sign, he says.
Cardiologists caution that chest pain is not something you should try to diagnose on your own. “You cannot determine if chest pain is serious with a Google search or by asking friends or family members (unless they are a physician),” says Dr. Bairey Merz. “‘You must get a diagnostic evaluation with a physician without delay.”
Heart attack signs and symptoms
Time is critical when you’re having a heart attack. You have about 90 minutes from the onset of the heart attack to restore the flow of blood to the heart before critical heart tissue dies or is damaged. Call 911 right away if you experience any of these heart attack symptoms:
- Pain in the middle of the chest that spreads to the jaw, back, or arms
- A feeling of heaviness in the heart, as if it is pounding out of your chest
- Sudden sweating
- Shortness of breath
- Loss of consciousness
- Bluishness of the lips, hands, or feet
Subtle heart attack symptoms in women
Many women will feel different kinds of symptoms than men when they have a heart attack. “Two-thirds of heart attack symptoms in men and one-third in women are typical, meaning radiation to the left chest and/or arm or jaw, shortness of breath, nausea, or sweating,” says Dr. Bairey Merz.
Because these symptoms are subtle and not accompanied by chest pain, they might be overlooked and blamed on stress, muscular pain, or digestion issues. Don’t shrug these off. A delay in diagnosis can cost valuable time in getting proper treatment or result in death, Dr. Bairey Merz says.
Subtle heart attack symptoms in women include:
- Sudden onset of weakness
- Shortness of breath
- Nausea or vomiting
- Heartburn or indigestion
- Body aches
- An overall feeling of illness
- Unusual feeling or mild discomfort in the back, chest, arm, neck, or jaw
- Sleep disturbance
Non-cardiac reasons for chest pain on the left side
The skin, nerves, muscles, bones, tendons, soft tissue, and cartilage all share real estate on the left side. If one of these areas is infected, inflamed, or injured, it could cause chest pain.
“Non-cardiac pain on the left side usually will present itself as pain that lasts for a few seconds or can be reproduced by pressing on your chest,” says Raj Khandwalla, MD, director of Digital Therapeutics in the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles.
Don’t dismiss the symptoms however. You still need to check in with your doctor.
“Symptoms that are new and/or severe require diagnostic evaluation urgently by calling 911 and/or going to the emergency department,” says Dr. Bairey Merz. “Symptoms that are new and less severe can be addressed by a call to the physician for decisions and diagnosis.”
Here are some of the more common causes of chest pain on the left side:
Chest wall or nerve pain
A strained or pulled muscle in the chest area, blunt force trauma to the chest area, or even recent surgery can cause the chest wall to hurt. Inflammatory arthritis of the sternum and rib cage, known as costochondritis, can also cause chest pain on the left side of your breastbone.
It happens when cartilage that connects the ribs to the breastbone becomes inflamed. The pain may be sharp, aching, pressure-like, or feel tender to the touch.
Chest pain is also an early symptom of shingles, a painful, blistering skin condition that occurs when the same virus that causes chickenpox is reactivated in the body. (The blisters, which tend to show up after the pain starts, are on one side of the body and typically affect the chest, face, or arms.)
Gastroesophageal reflux disease (GERD)
“The most frequent condition blamed for non-cardiac chest pain is typically heartburn (gastroesophageal disorder or GERD),” says Dr. Bairey Merz. “So this is likely also the most blamed for the left side if there is no evident skin, muscle, joint, or lung problem.”
Some of the same nerves serve the esophagus and the heart. So when chest pain from stomach acid moves up into the tube that connects the throat to the stomach, it causes a burning sensation, pressure, and tightness in the chest near the heart. GERD can also present as heart attack symptoms in that the chest pain radiates to the back, neck, jaw, or arms. The pain lasts anywhere from a few minutes to a few hours.
Other gastrointestinal issues
Various problems related to the stomach and intestines can generate pain that begins or spreads to the chest. The pain from an ulcer, which is a sore in the intestinal tract, can radiate to the chest.
Gallbladder disease can cause severe muscle spasms or painful pressure in the chest, extending to the upper back and breastbone—like heart attack symptoms.
Pancreatitis, stemming from the gastrointestinal region, produces pain in the middle of the body, under the ribs. But it can feel like an ongoing, drilling pain in the chest, too. In addition to chest pain, these gastrointestinal tract issues typically give you stomach pain, bloating, nausea, heartburn, gas, loss of appetite, and indigestion.
Problems related to the lungs can cause chest pain that feels worse every time you take a breath. Pneumonia is an infection of one or both lungs caused by bacteria, viruses, or fungi. Pain, cough, and fever ensue—and so does a sharp or stabbing chest pain that’s worse with deep breathing or coughing, particularly if the left lung is infected.
A pulmonary embolism is a blood clot in the lung. These are rare, but they can cause chest pain that occurs suddenly along with difficulty breathing, especially when you take a deep breath. Shortness of breath, coughing up blood, or pink, foamy mucus are also hallmark symptoms. Emergency treatment is critical for a pulmonary embolism.
A collapsed lung (called pneumothorax) can also cause chest pain that gets worse when you breathe or cough, and is usually accompanied by shortness of breath.
Panic attacks, anxiety, depression, and emotional stress caused by intense fear or discomfort may also cause you to feel pain in the chest. A panic attack often feels like a heart attack because you have a racing or pounding heartbeat that causes hyperventilation, which produces chest pain.
You may also experience symptoms that are similar to a heart attack, such as lightheadedness, shortness of breath, sweating, and nausea.
Broken heart syndrome
The stress that comes from a loved one’s sudden death, the abrupt firing from a job, or a catastrophic medical diagnosis can sometimes trigger a condition known as broken heart syndrome. “Broken heart syndrome mimics a heart attack,” says Dr. Kalra. “It causes pain predominantly on the left and lasts several minutes. It may radiate to the jaw, neck, back, arm or shoulder, and may be associated with perspiration or a drop in blood pressure—all similar to a heart attack.”
Unlike a heart attack, broken heart syndrome doesn’t cause blockage in the arteries, but the left ventricle (the heart’s main pumping chamber) will have an unusual and distinctive shape.
It typically resolves without lasting damage. While it can happen to men and women, women typically experience it more frequently.
Cardiac reasons for chest pain on the left
In addition to a heart attack, here are some more heart-related issues for chest pain on the left side. As Dr. Bairey Merz says, these are not conditions you can self-diagnose. Call 911 at once to get help.
Angina is a type of chest pain that happens if the heart muscle isn’t getting enough oxygenated blood, usually due to heart disease. It might happen when you’re exerting yourself (because the need for oxygenated blood will increase) and ease up with rest. Still, it’s a warning sign that you should call your doctor to rule out anything serious.
Unstable angina is chest pain that doesn’t dissipate with rest. (Compared with stable angina, which does go away with rest.) And it’s not the type of chest pain you mess around with—especially when you have other symptoms including chest pain that radiates to the throat or jaw, tightness or pressure in the chest, and pain down the arms and between shoulder blades.
Pericarditis is a condition in which the pericardium—the sac-like tissue surrounding the heart—becomes inflamed, often because of a viral or bacterial infection. When the condition is acute, chest pain begins suddenly and sharply and worsens with deep breaths or coughing.
Sitting up or leaning forward typically relieves chest pain. Other symptoms include shortness of breath while lying down, a dry cough, low-grade fever, abdominal or leg swelling, whole body weakness, and fatigue.
Inflammation of the heart muscle is known as myocarditis. Chest pain usually presents itself a week or two after a viral illness. Sharp chest pain ensues, along with an abnormal heart rhythm, a racing heart, and pale skin as the heart muscle’s inflammation gets worse.
Though myocarditis can be mild or severe, you can’t know which one applies to you. So don’t hesitate and get medical evaluation immediately.
The heart has four chambers. Heart valves connect the upper and lower chambers with flaps that open and close to ensure that blood flows in only one direction. Symptoms might not present with all heart valve issues, but seek medical help immediately if you have other symptoms including:
- shortness of breath (during activity or rest)
- fainting or loss of consciousness
- dizziness or light-headedness
- chest pain with exertion or exposure to the cold
- heart palpitations
- swelling in the ankles, feet, or stomach
Aortic dissection is a rare, but life-threatening cardiovascular condition in which the aorta, the largest artery in the body, tears. Many conditions increase the risk of aorta dissection, including trauma to the chest, hardening of the arteries, or a preexisting aneurysm.
Aortic dissection symptoms come on very suddenly, with severe chest pain that radiates to the back or between the shoulder blades. It’s often described as a ripping or tearing sensation.
Other symptoms are similar to a heart attack, including dizziness, nausea, vomiting, and shortness of breath. As with all cardiac reasons for chest pain on the left side, you should get emergency medical help right away.
Diagnosing chest pain on the left side
“When a person seeks medical evaluation for any chest pain that individual will receive an electrocardiogram,” says Dr. Khandwalla. “If suspicion is high for cardiac chest pain in the emergency room, they will receive blood tests to measure if there has been damage to the heart that would indicate the patient is having a myocardial infarction—or heart attack.”
Dr. Khandwalla said more tests might be needed to observe the blood flow, arteries, and muscle of the heart. For example, a stress test is done to see if there is decreased blood flow to the heart muscle. An echocardiogram visualizes the function of the heart muscle. And an angiogram using a CT scan or cardiac catheter to zoom in on the arteries of the heart and determine if there is a blocked artery.
Chest pain treatment
As the causes of chest pain vary, so do the treatments. For example, chest wall pain from arthritis or muscle strain might be treated with over-the-counter or prescription medications for pain and inflammation.
Antibiotics address bacterial heart infections or pneumonia, antacids for heartburn, “clot busters” to remove blood clots, and anti-anxiety medications for panic attacks. Nitroglycerin helps widen the blood vessels to get more blood flowing to the heart, and beta-blockers promote rest for the heart muscle, help with blood pressure and prevent an irregular heartbeat.
Finally, the chest pain associated with a pulmonary embolism may require surgery to improve blood flow and minimize new clots from forming, and valve repair or replacement in the case of aortic dissection.
- Noel Bairey Merz, MD, cardiologist, director of the Barbara Streisand Women's Heart Center in the Smidt Heart Institute at Cedars-Sinai, Los Angeles.
- Ankur Kalra, MD, an interventional cardiologist at the Cleveland Clinic, in Akron, Ohio.
- Raj Khandwalla, MD, director of Digital Therapeutics in the Smidt Heart Institute at Cedars-Sinai, Los Angeles.
- Cedars-Sinai: "Heart Attack (Myocardial Infarction)"
- The Society for Cardiovascular Angiography and Interventions: "Heart Attack and Conditions That Mimic Heart Attack: Learn About Chest Pain"
- UpToDate.com: "Patient education: Chest pain (Beyond the Basics)"
- UpToDate.com: "Patient education: Pericarditis (Beyond the Basics)"
- Cedars-Sinai: "Chest Wall Infections"
- Harvard Health: "Acute Pancreatitis"
- The Society for Cardiovascular Angiography and Interventions: "Angina and Other Causes of Chest Pain"
- The Society for Cardiovascular" Angiography and Interventions: "Myocarditis"
- The Society for Cardiovascular Angiography and Interventions: "Pericarditis"
- The Society for Cardiovascular Angiography and Interventions: "Symptoms of Heart Valve Disease"
- The Society for Cardiovascular Angiography and Interventions: "Aortic Dissection: A Rare Dangerous Condition That Can Mimic a Heart Attack"
- Johns Hopkins: "Broken Heart Syndrome"
- The Society for Cardiovascular Angiography and Interventions: "Diagnosing Heart-Related Chest Pain"