Possible description goal – “Know the causes and treatments of thoracic pain focused in the middle region. Find out when to seek medical attention for this discomfort.”

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Experimenting pain in the middle of the chest can be an distressing symptom that justifies immediate medical care. There are several factors that can contribute to this type of pain, from relatively harmless conditions to potentially mortal emergencies. It is crucial to identify the underlying pain of pain to determine the proper treatment.

  1. CostoCondritis: A possible cause of pain in the center of the chest is costocondritis. This condition refers to the inflammation of the cartilage that connects the ribs with the sternum. It can cause acute or sharp pain, which can worsen with deep movement or breathing. Costocondritis is usually caused by injuries, excessive cough or respiratory infections.
  2. Gastroesophageal reflux disease (EGE): Another possible culprit of chest pain is the Gee. This disease occurs when stomach acid returns to the esophagus, causing irritation and discomfort. The most common symptoms are burning stomach, regurgitation and burning sensation in the center of the chest. EGE can be triggered by certain foods, obesity, pregnancy or hiatus hernia.
Causes Symptoms Treatment


Acute or sharp pain that worsens with deep movement or breathing

Analgesics without recipe, application of heat or ice, rest and avoidance of activities that exacerbate the pain


Stomach burning, regurgitation and burning sensation in the center of the chest

Changes in lifestyle (such as avoiding trigger or maintaining healthy weight), medication (such as antacids or proton pump inhibitors) and head of the head when sleeping.

Pain in the Middle of Chest: Causes, Symptoms, and Treatment


  1. Gastroesophageal reflux disease (EGE): GERD occurs when stomach acid returns to the esophagus, which causes irritation and inflammation. This can cause a burning sensation or discomfort in the center of the chest.
  2. Musculoskeletal problems: chest pain can also be caused by problems in the muscles, ribs or joints of the thoracic area. Conditions such as Costocondritis (inflammation of the cartilage that joins the ribs to the sternum) or muscle distension due to excess physical activity can manifest itself as average chest pain.
  3. Cardiac conditions: although chest pain is usually associated with heart problems, not all cases indicate a heart attack. However, angina peer (reduction of blood flow to heart muscle) and other hear t-related problems can cause discomfort in the center of the chest.
  4. Respiratory conditions: the conditions that affect the lungs, such as pneumonia or pleurisy (inflammation of the lining that surrounds the lungs), can cause chest pain. This pain usually feels in the center of the chest or on one side.


  • Acute burning or pain in the center of the chest
  • Difficulty to swallow
  • Chest tightness
  • Difficulty breathing
  • Cough or wheezing
  • Palpitations or irregular beats

If you experience chest pain accompanied by severe respiratory distress, tachycardia or fainting, it is essential that you look for immediate medical attention, since these symptoms may indicate a myocardial infarction or other serious cardiovascular conditions.


The treatment of pain in the center of the chest depends on the underlying cause. Management strategies may include:

  1. Free sales antacids or prescription medications to reduce the production of stomach acid or neutralize acid reflux in cases of grade.
  2. Apply cold or hot compresses, take analgesics and avoid activities that aggravate the symptoms of chest pain of musculoskeletal origin.
  3. Medications for treating heart conditions, such as beta blockers or anticoagulants, prescribed by a healthcare professional.
  4. Antibiotics, rest and adequate intake of liquids for respiratory infections that cause chest pain.

However, it is crucial to consult a healthcare professional to obtain a precise diagnosis and an individualized treatment plan based on the specific cause and the severity of chest pain.

Understanding Chest Pain: An Overview

Causes and Risk Factors:

  1. Cardiac causes: chest pain can be a manifestation of hear t-related conditions, such as chest angina, myocardial infarction (heart attack) or pericarditis. The factors that increase the risk of suffering these conditions are the elderly, smoking, arterial hypertension, high levels of cholesterol and family history of heart disease.
  2. Pulmonary causes: conditions that affect lungs, such as pneumonia, pulmonary embolism and pleurisy, can cause chest pain. The risk factors of these lung conditions include a history of smoking, advanced age, obesity and a sedentary lifestyle.
  3. Gastrointestinal causes: Gastroesophageal reflux disease (GERD), gastritis and peptic ulcer are gastrointestinal conditions that can cause chest pain. Risk factors for these conditions are obesity, smoking, excessive alcohol consumption, and a diet rich in fatty and spicy foods.

It is important to note that chest pain should never be ignored, as it can sometimes indicate a life-threatening condition, such as a heart attack. Any chest pain should prompt immediate medical evaluation to rule out any serious underlying causes.

In addition to the causes mentioned, chest pain can also be due to musculoskeletal problems, anxiety or panic attacks, or even certain viral infections. It is essential that healthcare professionals carefully evaluate the characteristics of pain, including its location, intensity, duration and associated symptoms, to accurately diagnose and treat the underlying cause.

Common Causes of thoracic pain

1. Gastroesophageal reflux disease (GERD): One of the main causes of chest pain is GERD, a disease characterized by the reflux of stomach acids into the esophagus. This can lead to a burning sensation, commonly known as heartburn, which often radiates to the middle of the chest. The pain may worsen after eating, lying down, or bending over.

Important information: If you experience chest pain accompanied by difficulty breathing, sweating, or radiating to the arm, neck, or jaw, seek immediate medical attention, as these symptoms may indicate a heart attack. It’s always best to err on the side of caution when it comes to chest pain.

2. Musculoskeletal conditions: Chest pain can also be caused by various musculoskeletal conditions, such as costochondritis or muscle strain. Costochondritis refers to inflammation of the cartilage that connects the ribs to the breastbone, causing tenderness and chest pain. Muscle strain, for its part, can be due to overexertion or injury to the muscles of the chest wall, causing localized pain that can be aggravated by movement or deep breathing.

  1. Costocondritis
  2. muscle strain

3. Anxiety or panic attack: psychological factors, such as anxiety or panic attacks, can also manifest as chest pain. In times of greater stress or anxiety, people may feel oppression in the chest, a sense of weight in the chest or a feeling of imminent fatality. These symptoms can be distressing and imitate those of a hear t-related problem, which often causes unnecessary concerns and anxiety.

Common Causes of thoracic pain Symptoms
Gastroesophageal reflux disease (EGE) Stomach burning, get worse after eating or bed
Costocondritis Sensitivity, aggravated by movements or deep breath
muscle strain Localized pain worsens with movement
Anxiety or panic attack Chest oppression, heaviness, feeling of imminent fatality

Cardiac Causes: Is it a Heart Attack?

Understanding myocardial infarctions:

A heart attack, also known as myocardial infarction, occurs when the blood supply to the heart is completely blocked or blocked. This interruption of blood flow can cause damage or death of the muscle tissue of the heart and requires immediate medical attention. It is essential to recognize the symptoms of a myocardial infarction, since rapid intervention can greatly improve the prognosis.

Possible cardiac causes:

  1. Coronary arterial disease (EAC): One of the most frequent cardiac causes of chest pain is coronary arterial disease. The EAC occurs when the arteries that supply blood to the heart narrow or obstruct due to the accumulation of plate. This can cause chest pain, known as angina in chest, which can be a warning sign of an imminent heart attack.
  2. Myocardial ischemia: myocardial ischemia refers to a reduction in blood flow and oxygen supply to heart muscle. It can be caused by conditions such as spasms of coronary arteries or blood clot formation. Mioocardial ischemia can cause pain or discomfort in the chest, which can imitate the symptoms of a myocardial infarction.
  3. Arrhythmias: abnormal heart rhythms, also known as arrhythmias, can cause chest pain. These irregular beats can alter the normal functioning of the heart and cause discomfort or a heartbeat or chest flutter.

In summary, when experiencing pain in the center of the chest, it is essential to consider the possibility that it is related to a heart attack. Recognizing the symptoms of a heart attack and understanding the cardiac causes of chest pain can help determine the appropriate course of action and seek timely medical intervention. If you experience chest pain, it is always recommended to contact emergency medical services or a healthcare professional for evaluation and guidance.

Gastrointestinal Causes: Acid Reflux and Ulcers

Acid reflux, also known as gastroesophageal reflux disease (GERD), occurs when stomach acid flows back into the esophagus. This can cause a burning sensation in the center of the chest, known as heartburn. In addition to chest pain, acid reflux can cause regurgitation of stomach acid into the mouth, difficulty swallowing, and chronic cough. Certain risk factors, such as obesity, pregnancy, and hiatal hernia, can contribute to the development of acid reflux.

Important Information:

Acid reflux can be controlled with lifestyle changes, such as avoiding trigger foods, maintaining a healthy weight, and elevating your head when sleeping. Over-the-counter antacids and prescription medications can also relieve reflux by reducing stomach acid production.

Ulcers are sores that develop in the lining of the stomach or the upper part of the small intestine. The most common cause of ulcers is a bacterial infection called Helicobacter pylori (H. pylori), although certain medications such as non-steroidal anti-inflammatory drugs (NSAIDs) can also contribute. In addition to chest pain, ulcers can cause a gnawing or burning sensation in the stomach, indigestion, bloating, nausea, and vomiting.

Important Information:

Ulcers can be treated effectively with a combination of antibiotics to eradicate the H. pylori infection, medications to reduce stomach acid production, and lifestyle modifications. Untreated ulcers can lead to complications such as bleeding and perforation, so seeking medical attention is crucial.

Comparison Between Acid Reflux and Ulcers
Condition Cause Symptoms
acid reflux Heartburn that returns to the esophagus Heartburn, regurgitation, swallowing difficulties, chronic cough
Ulcers H. pylori infection, NSAIDs Chest pain, stomach discomfort, indigestion, bloating, nausea, vomiting

Musculoskeletal Causes: Costochondritis and Rib Fractures


Costocondritis, also known as chest wall pain, is the inflammation of the cartilage that joins the ribs to the sternum. This condition is usually presented as acute and localized pain in the center of the chest. It usually worsens with physical activity, deep breathing or pressure exerted on the affected area. Costocondritis may be due to repetitive efforts or chest wall lesions, viral infections or even underlying rheumatological disorders. Although the exact cause of the costocondritis may vary, pain is usually characterized by sensitivity and swelling in the affected area.

Rib Fractures:

The costal fractures refer to the breakage or fissure of one or more ribs. This type of injury can be a consequence of a thoracic trauma, such as a direct blow or a strong cough. Rastic fractures can cause important chest pain, especially on the injured side. The pain usually exacerbates when breathing, coughing or moving the upper body. Other symptoms can be bruise, swelling and sensitivity in the place of fracture. In severe cases, sack fractures can cause breathing difficulties, since the movement of the rib cage is compromised.

Comparison of costocondritis and costal fractures
Characteristics Costocondritis Costal fractures
Pain Acute and located in the center of the thorax Important pain on the injured side
Aggravating factors Physical activity, deep breathing, pressure Breathing, cough, movement
Causes Repetitive efforts, injuries, viral infections, rheumatological disorders Thoracic trauma
Additional symptoms Sensitivity, swelling Moratones, swelling, breathing difficulty

It is important to seek medical attention for adequate diagnosis and treatment of both costocondritis and costal fractures. Costocondritis is usually treated with analgesics, rest and soft stretching exercises, while sack fractures may require immobilization, pain and monitoring treatment to control the progress of healing.

Respiratory Causes: Pneumonia and Pulmonary Embolism

Pneumonia: Pneumonia is an infection that affects the alveoli of one or both lungs. It can be caused by bacteria, viruses or fungi, and usually pursue with symptoms such as chest pain, coughing with phlegm, fever and difficulty breathing. This condition can be especially worrying for people with weakened immune systems or underlying respiratory conditions.

Pulmonary embolism: Pulmonary embolism occurs when one or more blood vessels in the lungs become blocked by a blood clot. This condition can be life-threatening and requires immediate medical attention. The most common symptoms are sudden sharp chest pain, difficulty breathing, tachycardia, and coughing up blood. Risk factors for pulmonary embolism include prolonged immobility, surgery, obesity, and a history of blood clots.

Important Information:

  • Pneumonia is an infection that affects the lung alveoli.
  • Symptoms of pneumonia are chest pain, cough with phlegm, fever and difficulty breathing.
  • Pulmonary embolism occurs when a blood clot blocks the blood vessels in the lungs.
  • Pulmonary embolism causes sudden chest pain, difficulty breathing, tachycardia, and coughing up blood.
  • Immediate medical attention is crucial for both pneumonia and pulmonary embolism.

Recognizing the possible respiratory causes of chest pain is essential to seeking appropriate medical care and ensuring appropriate treatment. If you are experiencing chest pain along with other concerning symptoms, it is advisable to consult a healthcare professional for a thorough evaluation and diagnosis.

Anxiety and stress: Psychological factors

Anxiety, characterized by excessive worry and fear, can manifest with a variety of physical symptoms, one of which is chest pain. Chest pain associated with anxiety is often described as a sharp, stabbing sensation or a feeling of tightness or pressure. This can be alarming for people who experience it, as it can mimic the symptoms of a heart attack. It is important to note that anxiety-related chest pain usually occurs in the absence of an identifiable physical cause, and the discomfort tends to decrease or disappear with relaxation.

  • Anxiety and stress can contribute to chest pain
  • Chest pain associated with anxiety is often described as sharp or squeezing.
  • Psychological factors can mimic the symptoms of a heart attack

Note: It is essential to consult a healthcare professional to rule out any underlying physical causes of chest pain and receive an accurate diagnosis. Only a medical professional can determine if chest pain is related solely to psychological factors or if further investigation is necessary.

Stress is another psychological factor that can contribute to chest pain. When a person is under significant stress, their body releases stress hormones, such as cortisol, which can affect various body systems. Chronic stress can cause muscle tension and stiffness, including in the chest area, which can lead to discomfort or pain.

  1. Psychological stress can trigger the release of stress hormones
  2. Stress-related muscle tension can cause chest pain

It is important to address anxiety and stress as part of the overall treatment plan for people suffering from chest pain. Techniques such as relaxation exercises, therapy, and stress management strategies may be helpful in reducing the frequency and intensity of chest pain episodes. Additionally, seeking professional help from a mental health professional can provide valuable support and guidance in managing symptoms related to anxiety and stress.

Anxiety and stress: Psychological factors
Anxiety – Excessive worry and fear – Chest pain described as sharp or squeezing
Stress – Release of stress hormones – Muscle tension that causes chest discomfort
Treatment – Relaxation exercises – Therapy and stress control strategies

Seeking Medical Help: When to Worry and What to Expect

When to worry:

  1. If you experience sudden, severe chest pain, especially accompanied by difficulty breathing and dizziness, it is essential that you seek immediate medical attention. These symptoms could be signs of a heart attack or other life-threatening conditions.
  2. Any chest pain that lasts more than a few minutes and radiates to the arms, shoulders, neck, or jaw should also be taken seriously. It could be a sign of angina or heart-related problems that require medical evaluation.
  3. People with a history of heart disease, hypertension or diabetes should be especially cautious and seek medical help if they experience any chest discomfort. These underlying conditions can increase the risk of cardiovascular complications.

What to expect:

During a medical evaluation for chest pain, a healthcare professional will conduct a thorough evaluation of your symptoms, medical history, and perform a physical examination. This will help them determine the possible causes and severity of your chest pain.

They may also perform diagnostic tests to obtain more information. These may include:

  1. Electrocardiogram (ECG) to evaluate the electrical activity of your heart.
  2. Blood tests to check levels of cardiac enzymes and other indicators of heart damage.
  3. Echocardiogram to create detailed images of the structure and function of your heart.
Diagnostic tests Indications
stress test To evaluate how your heart is working during physical activity.
Cardiac catheterization It is used to diagnose clogged arteries or narrowed blood vessels in the heart.
Computed Tomography (CT) To visualize the heart and surrounding blood vessels in more detail.

Based on the results of these evaluations, the doctor will determine the most appropriate course of action, which may include further testing or treatment options. It is essential that you be open and honest with your doctor about your symptoms and concerns to ensure an accurate diagnosis and appropriate treatment of your chest pain.

Author of the article
Dr.Greenblatt M.
Dr.Greenblatt M.
Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont

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