Chest pain left side middle of breast

Heart disease not the only reason for that feeling of angina

Although chest pain is often—and rightfully— associated with heart disease, other medical problems can be causes of chest pain. Angina—feelings of pressure, heaviness, tightness. or pain in the chest—occurs when plaque in the coronary arteries partially blocks blood flow and the heart muscle isn't getting enough oxygen and nutrients. (You can learn more about angina in the Harvard Special Health Report Diseases of the Heart: A compendium of common heart condition and the latest treatments.) Yet the heart isn't the only organ in the upper abdomen, and chest pain may be due to conditions affecting the esophagus, lungs, gall bladder, or stomach.

Digestive causes of chest pain

When chest pain—particularly pain in the lower chest— is triggered by a meal, it is likely to emanate from the digestive system, rather than from the heart, and can be due to the following:

Acid reflux or heartburn. When acid from the stomach flows up into the esophagus, it can cause a burning sensation in the chest reminiscent of a feeling of angina  or often mistaken for a heart attack.

Esophageal spasm.  Sudden, forceful contractions of the esophagus, the muscular tube between the mouth and the stomach, can be painful. These spasms can also trap food in the esophagus and prevent it from passing into the stomach.

Gallbladder disease. A sudden pain that often occurs 30 minutes after you have eaten may be a sign of gallstones. Gallbladder pain is usually felt just below the breastbone and may extend to the right arm or between the shoulder blades. It occurs as the gallbladder contracts in an effort to pump bile around the gallstones that are blocking its passage to the liver.

Inflammatory causes of chest pain

Tissues in the chest cavity can become inflamed due to injury, infection, or autoimmune conditions, in which the body's immune cells attack its own tissues. Common inflammatory causes of chest pain include the following:

Costochondritis. This condition, an inflammation in the chest wall between the ribs and the breastbone, can trigger a stabbing, aching pain that's often mistaken for a heart attack. Costochondritis is commonly caused by trauma or overuse injuries, often during contact sports, or it may accompany arthritis.

Pericarditis is an inflammation of the pericardium, a protective, double-layered sac surrounding the heart. It has many different possible causes, including a virus or other infection, certain illnesses, an injury to the chest, radiation therapy for cancer, or a reaction to medications. The classic symptom of pericarditis is a sharp, stabbing pain in the center or left side of the chest that worsens when you take a deep breath or lie down. The pain results from the irritated layers of the sac rubbing together.

Lung-related causes of chest pain

The following lung conditions often produce chest pain that may feel like angina. 

Pneumonia can cause shortness of breath and sharp pains that intensify with a deep breath. Unlike angina, it is likely to be accompanied by other symptoms, like fever, chills, or coughing.

Pulmonary embolism—a blood clot that has traveled into the vessels supplying the lungs—can cause chest pain. The pain is often accompanied by a fast or irregular heartbeat, sudden difficulty breathing, or feeling lightheaded or faint. Pulmonary embolisms can be life-threatening, so the symptoms warrant a call to 911.

Psychological causes of chest pain

Both anxiety and panic attack can cause symptoms very similar to angina. These attacks—which can occur out of the blue or in response to a stressful event—include chest pain along with shortness of breath, palpitations, and dizziness. The key difference is that the chest pain is usually fleeting, lasting only a moment or two.

What to do when you're uncertain

Any time you're uncertain about the source of chest pain that is recurrent or lasts for several days, you should talk to your clinician. However, if you have chest pain that is building in intensity, has lasted for several minutes, and isn't relieved by resting, you should get immediate medical attention.

• What Is Chest Pain?
  • What is chest pain?
• Signs and Symptoms
  • Signs and symptoms of chest pain on the left side above a female breast
• Causes
  • Causes of chest pain on the left side above a female breast
• When to See a Doctor
  • When to see the doctor for chest pain on the left side above a female breast
• Diagnosis
  • Diagnosing chest pain on the left side above a female breast
• Treatment
  • Treatments for chest pain on the left side above a female breast
• Related Resources
  • Related Resources - What Does Chest Pain on the Left Side Above a Female Breast Mean?

What is chest pain?

Chest pain on the left side above a female breast may be due to heartburn, a panic attack, gallbladder disease, gallstones, peptic ulcer and pneumonia.

There are numerous vital organs on the left side of the body. Under the left breastbone are the heart, spleen, stomach, pancreas, and large intestine. When you have chest pain on the left side above your breast, it can be caused by a variety of things. It is important to pay attention to other symptoms in addition to the pain to determine if you should seek medical attention. 

In some cases, pain in the chest may be angina which is a warning sign for heart disease. Angina happens because your heart muscle is not getting enough oxygen-rich blood. The pain feels like pressure or squeezing in your chest. The pain can spread from your left chest to your shoulders, neck, jaw, or back. This is similar to a heart attack. 

If you are experiencing prolonged chest pain on the left side, you should first rule out a heart attack before moving forward with treatment. Signs of a heart attack include: 

• Chest pain 
• Shortness of breath
• Cold sweat, nausea, and lightheadedness
• Discomfort, numbness, or pain in one or both arms, neck, stomach, jaw, or back
• Squeezing sensation, fullness, or uncomfortable pressure in the center of your chest

Signs and symptoms of chest pain on the left side above a female breast

It can be difficult determining exactly where your pain is coming from. Especially chest pain, because the nerves in your chest do not always indicate the specific cause of the pain. It is important to determine if your chest pain is related to your heart. If it is not, there are other causes to consider. Chest pain on the left side can also be connected to other symptoms that might help you locate the cause. 

Related symptoms of chest pain on the left side above a female breast include: 

Pressure in the chest

Pressure in your chest on the left side can be an indicator of heart attack. It may feel like someone is sitting on your chest. However, this feeling can also be a symptom of angina which can indicate heart disease.

Radiating pain

Your pain can spread from your chest to your jaw, neck, shoulders, or back. It’s important to track where your pain started and where it spread. 

Dizziness

Feeling lightheaded can accompany chest pain on the left side. If you feel out of breath or dizzy, you should consult your doctor and tell them your symptoms. 

Chest pain on the left side can present in classic ways with normal symptoms, but when it’s accompanied by other symptoms it becomes worrisome. 

Causes of chest pain on the left side above a female breast

Chest pain on the left side can have a variety of causes. After ruling out angina and heart attack, there are other causes you should look for. Those include: 

Heartburn

This is a frequent cause of chest pain. It’s related to indigestion and can feel like your heart is on fire. However, your heart is not affected by heartburn. It is actually your esophagus that burns from stomach acid coming up into your throat. 

Panic attack

A panic attack can have symptoms that mimic angina, and can cause your heart rate to increase, trembling, shortness of breath, dizziness, and chest pain. This is a psychiatric condition that needs to be treated by a mental health specialist.

Gallbladder disease

Gallstones and other gallbladder issues can cause pressure and extreme muscle spasms in your upper right stomach that can radiate to your chest, making you feel pain in your left chest. 

Peptic ulcer

These are sores that develop in your stomach due to acid from your digestive tract eating away your stomach, esophagus, or small interesting lining. Most often you will feel the pain in your stomach, but it can radiate to the middle or left of your chest. These sores are very painful and will require medication.

Pneumonia

Because your lungs are located in your chest underneath your breasts, symptoms of pneumonia can cause pain in your left chest above your breast. 

When to see the doctor for chest pain on the left side above a female breast

If you experience additional symptoms to your chest pain on the left side and are uncertain about the source of the pain, you should immediately seek medical attention. This includes chest pain that gets increasingly worse and is not relieved by treatments at home, including rest and nonsteroidal anti-inflammatory drugs.

Diagnosing chest pain on the left side above a female breast

To diagnose the cause of your chest pain on the left side your doctor will discuss your symptoms and may run blood tests. They also may take X-rays or order an electrocardiogram (EKG) and exercise stress test. They will want to rule out a heart attack or other heart problems.

The doctor may also evaluate you for microvascular angina—this can occur when your heart’s arteries are not supplying enough oxygen-rich blood due to spasm or cellular dysfunction. Once heart problems have been ruled out, they will look for other signs of trauma to your chest and breast and may run further tests to determine if it is related to another illness. 

Treatments for chest pain on the left side above a female breast

Since there are many causes for chest pain on the left side, there may be different treatments that your doctor will prescribe based on your diagnosis. If it is determined that you have microvascular angina the doctor will prescribe medication including:

• Nitroglycerin to dilate and relax arteries
• Beta blockers to slow heart rate
• Statins to slow the progression of fatty plaque in your arteries
• Calcium channel blockers to relax blood vessels

The underlying cause of your chest pain will determine the urgency and extent of the treatment. If your chest pain is not related to your heart, the doctor may recommend the following treatments: 

• Antacids or acid reducers to prevent reflux and heartburn
• Anxiety medication
• Surgery on one of the organs under your left side if they are the cause

SLIDESHOW

Medically Reviewed on 3/8/2021

References

SOURCES:

American Heart Association: "Heart Attack Symptoms in Women."

Harvard Health Publishing: "Other conditions may be causes of chest pain."

Johns Hopkins Medicine: "Microvascular Angina: Why Women Shouldn’t Ignore Chest Pain and Fatigue."

Medical News Today: "Chest pain in women: what causes it, and how do doctors diagnose it?"

National Heart, Lung, and Blood Institute: "Angina."

UNC Health Talk: "Is Your Chest Pain a Sign of a Heart Attack, or Something Else?"

The University of Alabama at Birmingham: "Chest pain: It’s not always a matter of the heart."

Yale Journal of Biology and Medicine: "Women and Chest Pain: Recognizing the Different Faces of Angina in the Emergency Department."

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