Chest pain is a common and one of the most discussed experiences. Chest pain is a feeling of pain and discomfort in the area of thoracic cavity or chest, extending from the neck to the upper abdomen.

What Can Cause Pain In Center Of Chest

A slight pain in the chest area can send waves of fear running down your mind. You are sure to think what could have caused this chest pain? Pain in chest is often feared of and is attributed to a heart attack. While this is a possibility, there are a host of other causes of chest pain.

When you experience pain in the center of chest, you would like to consider various other reasons that could be bothering you in the form of chest pain. The pain in center of chest can be of dull and constant type or chest pain that may come and go. Sometimes pain in center of chest may occur on stretching, exercising, breathing deeply or lying down.
A careful history and examination can guide towards the possible causes of chest pain in center of chest.

Causes Of Pain In Center Of Chest

The cause of chest pain can range from mild to severe ones that require immediate medical attention. The chest cavity encompasses many organs, bony structures, soft tissues and blood vessels. The chest portion is surrounded by neck, shoulders, upper back and upper abdomen; hence concerns in these parts can also contribute to chest pain.

Some of the causes of pain in center of chest can be classified as:

Pain In Center Of Chest Caused Due To Digestive System Disorder

Gastrointestinal disorders are usually the most common cause of chest pain, especially in the center, under the breast bone. These are mostly related to intake of particular food, appetite changes and other gastric symptoms. Pain in center of chest after eating is commonly caused due to digestive system disorders listed below:

  • Indigestion/Bloated Abdomen – Abdominal bloating or gas can cause severe pain under the center of the chest, with excessive burping or flatulence.
  • Gastro Esophageal Reflux Disease (GERD)/Heartburn – Regurgitation of stomach contents and acid into the esophagus can cause irritation and burning pain in middle of the chest.
  • Gastritis/Gastric/Peptic Ulcers – An inflammation or ulceration in the esophagus, stomach or duodenum, can cause burning sensation and chest pain in the center or middle of the chest pain.
  • Esophageal Disorders – Disorders that cause difficulty and pain during swallowing, e.g. esophageal varices, hiatus hernia, etc. can cause middle chest pain.
  • Gallbladder/Liver Disorders – Inflammation of liver, pancreas or gallbladder and gallstones can cause abdominal pain extending to the chest at times.

Musculoskeletal Causes Of Pain In The Center Of Chest

  • Bone Disorders – Bone and joint related conditions like osteomyelitis or certain infections can cause chest pain. Inflammation of rib cartilage (costochondritis) can cause chest pain in center, at the breastbone.
  • Muscle Soreness – Sore or strained muscles, fibromyalgia, chronic pain syndrome can cause muscular pain in the middle of the chest area. It is also usually the cause for pain in center of chest while lying down.
  • Injury – Injury to the soft tissues, bones or ribs and rib fracture can cause severe chest pain and restricted movements.

Cardiovascular Or Heart Related Causes For Pain In Center Of Chest

Heart related conditions can be serious and need immediate medical care.

  • Heart Attack / Angina - A blood clot or blocked arteries can obstruct the blood flow to the heart. This can cause severe tightness and crushing pain in chest or center of chest area, which may radiate to arms, jaw, neck or back. This may be associated with sweating and breathlessness.
  • Pericarditis – The sac surrounding the heart may get inflamed causing chest pain in the center. The pain may be sharp and can worsen on breathing or lying down.
  • Blood Vessel Disorder – Conditions affecting the blood vessels of the heart, causing damage or rupture, e.g. aortic dissection, can cause severe chest pain.

Pulmonary Or Lung Related Causes For Pain In Center Of Chest

Pain in the center of chest while breathing is usually linked to problems related to lungs as listed below:

  • Pulmonary Disorders – Lung disorders that involve inflammation of tissues or an infection can cause chest pain in varying degrees. For e.g. pleurisy (inflammation of membrane covering the lungs), chronic obstructive lung disease (COPD), pneumonia etc. Most of these conditions have long lasting respiratory symptoms, cough and breathing difficulty or sometimes fever.
  • Lung Collapse – When air escapes into the space between the ribs and lung (pneumothorax), the lung collapses and may have sharp chest pain.
  • Pulmonary Embolism – A blood clot may block the artery to the lungs and restricted blood flow can lead to chest pain.
  • Pulmonary Hypertension – Increased blood pressure in the lungs arteries can cause pain in chest.

Other Causes Of Pain In Center Of Chest

Some other causes of middle chest pain include

  • Viral infections like shingles
  • Panic attack, which may be accompanied by fear, rapid breathing and increased heart rate.

Diagnosis Of Pain In Center Of Chest

Appropriate investigations are done, depending on the complaints.

  • Blood Tests – For infections, cardiac enzymes, etc.
  • Electrocardiogram (ECG) – For heart muscle functioning
  • Chest X-ray – For lung disorders, rib fractures or bone disorders
  • Computerized tomography (CT Scan) – Lung diseases, blood clots, vascular and other disorders.

Treatment Of Pain In Center Of Chest

Treatment varies according to the cause. Anti-inflammatory drugs may be given for musculoskeletal strains or injuries, antacids for gastritis, blood thinners in case of clots and other condition specific treatment. In some heart disorders, surgical intervention like stent placement, bypass surgery, repair of aortic dissection may be advised.

Know The Risk Factors Of Heart Disease

While a heart disease can occur in any person, some identified risk factors include:

  • Being overweight
  • Having heart disease
  • Having a family history of heart disease
  • Having high blood pressure, diabetes, high cholesterol.

Know The Warning Signs Of Pain In Center Of Chest Or Middle Chest Pain

As many systems could be involved in a chest pain, it is important for you to know the warning signals or red flags. These may need urgent medical care.

  • Sudden, sharp pain in chest with crushing or squeezing feeling
  • Pain extending to neck, jaw, left arm and shoulders
  • Feeling of breathlessness, palpitations, sweating, nausea and dizziness
  • Intense chest pain, discomfort, uneasiness and breathing difficulty that is prolonged than usual.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: March 5, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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