Retrosternal Chest Pain: Causes, Symptoms, Treatment

What is Retrosternal Chest Pain?

The pain which occurs behind the sternum bone is known as retrosternal chest pain. The sternum bone, commonly known as the breastbone is a flat bone which can be found on the center of the chest. People commonly experience pain behind the sternum and the causes of retrosternal pain can be many. Retrosternal pain is mild in some individuals while in many others it is quite severe and prevents a person from performing the day to day activities.

What is Retrosternal Chest Pain

It is commonly seen that many people experience retrosternal pain at some point of time in their lives though the cause may vary from person to person. The symptoms too differ depending on the cause of retrosternal chest pain.

Many other structures like the heart, great blood vessels, thymus gland, trachea, cervical and thoracic vertebrae, esophagus and bronchi lay in the center of the chest cavity. There can be various causes of retrosternal chest pain, particularly common are those related to the organs situated in this region.

Here are the major causes of retrosternal chest pain.

Causes of Retrosternal Chest Pain

Some of the causes of retrosternal chest pain are quite simple and can be treated easily while some major causes may require immediate medical attention.

The Commonest Causes of Retrosternal Chest Pain are:

  • Gastrointestinal Problems – Retrosternal chest pain can be caused due to gastrointestinal problems, mainly related to the oesophagus as it lies right behind the sternum. Some of the most common causes associated with the oesophagus which can lead to such a pain are esophageal ulcer, esophagitis, acid reflux and obstruction caused due to a foreign body.
  • Respiratory Problems – When a disease occurs in the respiratory tract, it too can cause retrosternal chest pain, which can be quite severe in nature. Hemothorax, pneumonia and pleuritis are some of the lung diseases which can cause pain in the center of the chest just beneath the breastbone. Conditions like cancer in the mediastinum tissue or bronchus too can cause retrosternal chest pain from time to time.
  • Cardiac Problems – Moderate to severe retrosternal chest pain is the result of cardiac problems in the body. This can involve problems such as heart attacks, heart fibrillation, pericarditis, angina and also mitral valve prolapse. When cardiac problems are the causes of retrosternal chest pain, it usually needs immediate medical attention.
  • Tumors – Malignant (cancerous) or benign (non-cancerous) tumors can also be one of the major causes of retrosternal chest pain. If all the other symptoms also indicate a tumor then it is advisable to opt for a MRI, CT scan or chest X-ray to confirm the same and start treatment accordingly.

Symptoms of Retrosternal Chest Pain

The retrosternal pain in the chest area indicates that there is a medical issue that needs to be taken care of. The onset of such a pain might be abrupt or might remain mild for several days before becoming severe. If it is angina pain then it remains for just a few days while in cases of cancer or pneumonia, it may linger for several days.

Along with the pain which is often told to be stinging, agonizing, compressing and crushing, there are also other associated symptoms of retrosternal chest pain which help identify the problem.

  • A sour taste in the mouth lingers around, especially when going to bed at night or on waking up in the morning. This commonly occurs when acid reflux disease is the main cause of retrosternal chest pain.
  • It is usually difficult to swallow solid food items as the esophagus is obstructed or cancer cells are growing inside it. This is a common symptom of retrosternal chest pain in case of esophageal obstruction or cancer.
  • If the cause of the chest pain is a respiratory disease then the patient is most likely to experience related symptoms such as aggravated pain during normal breathing. Cough, fever, reduced appetite and also expulsion of bloody sputum.

With time, the pain can worsen and may be accompanied by an increased heart rate, perspiration, breathlessness, dizziness and vomiting. Symptoms of radiating pain from the left arm and change in color of the nails and tongue can be an indication of a serious condition. If you experience such symptoms of retrosternal chest pain, you must visit a doctor immediately.

Treatment of Retrosternal Chest Pain

Treatment mainly depends on the underlying cause of retrosternal chest pain. In most of the cases, the pain is controlled with medications. In cardiac issues like heart attack or angina, the artery blockage is cleared with medications thereby reducing pain and treating the problem. In the same manner, hypertensive medicines are given to treat hypertension. If a blood clot forms in the chest region, the doctor might also advice some blood thinning medications along with it.

In cases where the underlying cause is acid reflux, doctors prescribe medications which help suppress the excess production of acid in the stomach, which improve digestion and antacids. Respiratory conditions like pneumonia are controlled with a combination of painkillers and antibiotics; together which help to relieve retrosternal chest pain.


Retrosternal pain whether mild or severe should not be ignored. You will never know when it turns into a major disease and can prove to be fatal. However, the key to treating such a pain is to first find out the underlying cause as that alone will guide the right treatment for retrosternal chest pain.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:February 7, 2018

Recent Posts

Related Posts