Can Right Sided Chest Pain be Cardiac?

Chest pain is defined as any pain that is experienced anywhere in the anterior thoracic area extending from the shoulder to the bottom of rib cage. Most of the time, chest pain generates a fear of sudden heart attack, but it should be noted that not all chest pain are caused due to cardiac disorders. Rather, it can be due a multiple reasons. Chest pain is very common; however, should never be ignored. It should be considered as a serious issue and one should seek medical attention at the earliest. Prompt follow up with a physician can help in diagnosis of the underlying problem and prevent any serious threats associated with it.

It is often seen that, people consider left sided chest pain more serious than right sided chest pain as the heart lies in the left side of the chest. Though possibilities of cardiac issues with left sided chest pain is higher than with right sided chest pain, but that does not mean that we can ignore right sided chest pain.

The chances of right sided chest pain being cardiac related issue are less as compared to left sided chest pain. However, it cannot be said that right sided chest pain are never cardiac. In cases of right sided chest pain being cardiac in origin, the following symptoms may accompany:

• Sudden pressure or tightness under the breast bone.
• Pain radiating to left arm, jaws or back can be indicative of right sided chest pain being cardiac.
• Loss of sensation in extremities.
• Difficulty breathing or gasping can also be a symptom of right sided chest pain which is cardiac in nature.
• Increased heart rate, nausea, dizziness, light-headedness, disorientation, rapid breathing, pale skin, and excessive sweating.

In some cases, symptoms may include low blood pressure and reduced heart rate.

Right sided chest pain can be a serious issues, but not always necessarily cardiac in origin. However, though not caused by heart issues, it can still represent presence of other health condition that may require immediate attention. This includes gall bladder inflammation, liver inflammation, gastrointestinal issues and angina.

Right Sided Chest Pain Caused Due to Angina: Angina is a condition characterised by diminished blood flow to the cardiac muscles. This can lead to right sided chest pain associated with cardiac issues.

Other causes of right sided chest pain are:

• Right Sided Chest Pain Caused Due to Viral Infections: Viral infections associated with cold and flu symptoms often leads to chest pain. This may worsen with continuous coughing and deep breathing that may strain the muscles over the chest and rib cage causing pain.
• Pleural Inflammation Can Cause Right Sided Chest Pain: Inflammation of the tissue that surrounds the lung can present itself as chest pain. This is associated with upper respiratory disorders and other lung issues.
• Right Sided Chest Pain Caused Due to Gastritis: Inflammation of the gastric lining can cause abdominal pain radiating to the right side of the chest. This can also happen with alcohol consumption, fasting, and excessive consumption of fatty food that may irritate the stomach lining.
• Gall Bladder Issues as a Cause for Right Sided Chest Pain: Gall bladder irritation most commonly presents itself as right sided chest pain. This is due to the anatomic position of the gall bladder. This pain worsens after eating fatty food. Right sided chest pain can also be caused by gall stones.
• Right Sided Chest Pain Caused Due to Digestive Disorders: Digestive issues, particularly in relation to the oesophagus can mimic chest pain. GERD or heart burn can manifest itself as right sided chest pain. Chest pain can be also caused due to blockage of food in the food pipe.
• Liver Disorders as a Cause of Right Sided Chest Pain: Liver disorders like inflammation of the liver and hepatitis causes pain in the chest, shoulder, rib cage and back predominantly on the right side.
• Right Sided Chest Pain Due to Inflammation of Pancreas: Chest pain can also be secondary to inflammation of the pancreas.
• Chest Injuries Causing Right Sided Chest Pain: Injuries and trauma over the chest and rib cage can cause immense pain of the chest. This can also be associated with neck problem and fracture of ribs.
• Tumours and Cancerous Lesion to Cause: Tumours and other lesions within the chest area and lungs can irritate the surrounding areas and cause right sided chest pain.
• Other Causes of Right Sided Chest Pain: Other causes could be due to side effects of antacids, muscle pulls, stress and excessive physical activities.

Besides the obvious pain over the thoracic area, chest pain due to reasons other than cardiac can be accompanied by the following symptoms:

• Discomfort under the breast bone.
• Acid reflux / heartburn.
• Swallowing difficulties.
• Pain upon lying down or while changing positions.

The first step in diagnosis of chest pain includes obtaining thorough case history followed by physical examination by an experienced physician. Emergency intervention may be necessary in cases of cardiac issues and heart attacks. Based on the clinical findings, the following investigations may be suggested:

• ECG to Rule Out if Right Sided Chest Pain is Cardiac: This is used for determining the functioning of the heart.
• Blood Tests to Check if Right Sided Chest Pain is Cardiac: Tests are carried out to determine the troponin level which suggests if the pain is due to myocardial infarction i.e., heart attack or unstable angina. Specialized tests such as D-dimer tests may be suggested too.
• Chest X-ray: X-rays are done to study the lungs closely and for ruling out conditions such as rib fracture, pneumonia etc.
• Myocardial Perfusion Scintigraphy: This is done to rule out possibilities of angina and cardiac issues.
• Angiogram to Determine Right Sided Chest Pain as Cardiac or not: Here a dye is injected into the coronary arteries and then studied under a specialized x-ray equipment to check for cardiac issues behind right sided chest pain.
• CT scan: Suggested for further investigation and evaluation.
• Endoscopy: This is used to study the digestive system related causes for right sided chest pain.

Treatment is given depending on the cause of chest pain. Right sided chest pain could be cardiac at times. Hence, if the above mentioned symptoms are experienced, it is advised to call or visit the emergency room at the earliest for necessary medical assistance to avoid any further complications.