What It Could Mean If You Have Right-Side Chest Pain
Chest pain on the left side gets all the attention because it is associated with a heart attack, but right-side chest pain may or may not be serious too. Here's what symptoms of right-side chest pain could mean, according to cardiologists.
Is right-side chest pain a big deal?
Although it may not seem like as big a deal, chest pain on the right side can be cause for concern, too. Right-side chest pain may be a sign of something less worrisome, like muscle pain. Or it may indicate a more serious health problem related to the heart or lungs.
“The cause of chest pain is often difficult to diagnose,” says Raj Khandwalla, MD, cardiologist and director of Digital Therapeutics in the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles. “That’s why you should always see a physician if you’re having any type of chest pain—even if it’s on the right side.”
To repeat: If you have chest pain, you should always consult your healthcare provider to get their opinion or a diagnosis.
That said, if you are a chronic worrier or prone to anxiety about your (relatively mild) aches and pains, know that your chest pain might be due to muscle pain, coughing, or something relatively benign that may go away on its own.
Why it can be difficult to diagnose chest pain on the right side
The chest cavity is the second-largest hollow space in the body after the abdominal cavity. Within the chest are some major players such as the heart, ribs, lungs, and esophagus—as well as nerves, arteries, blood vessels, muscle, bones, and connective tissue. That’s a lot of moving parts, and the reason why pain within the chest cavity is so tricky to diagnose, Dr. Khandwalla says.
Dozens of conditions can cause chest pain on the right side. Some are directly related to the right side because an organ such as a lung is there, or it could be referred pain.
Referred pain is when you feel pain in one part of the body (such as the right side of the chest area) caused by pain from an injury or illness in another part of the body. For example, a person may have heart attack symptoms—such as pain in the jaw, neck, or back—but the source of pain originates from the heart.
“If I take a hammer and smash my finger, I will feel the pain at the exact location of the injury. The same is not true of the chest due to the complexity of how the nerve fibers are arranged throughout the chest,” says Dr. Khandwalla. “Consequently, it is difficult to localize pain in the chest, so a problem on the left side of the chest can present itself as pain on the right side, shoulder pain, or even neck and jaw pain.”
Here are a few things that can cause right-side chest pain, from relatively mild and common problems, to the more rare and serious.
Heart attack and right-side chest pain
If you have chest pain that gets worse or is triggered by physical activity or stress, and it goes away with rest, that could be angina, which is chest pain due to heart disease. Resting doesn’t make a difference when it’s pain caused by a heart attack.
If your right-side pain is also accompanied by symptoms of dizziness, lightheadedness, or shortness of breath—you should seek medical attention immediately, as it could signify a heart attack, says Ankur Kalra MD, an interventional cardiologist at the Cleveland Clinic in Akron, Ohio.
As a reminder, these are the symptoms of a heart attack. Call 911 to get help.
- Chest pain or discomfort with pressure or tightness
- Feeling weak, lightheaded, or dizzy
- Sudden fatigue
- Cold sweats, perspiration
- Pain or discomfort in the jaw, neck, or back
- Pain or discomfort in one or both arms or shoulders
- Shortness of breath
It’s important to note that some women might experience different heart attack symptoms than men. Only about one-third of women have the typical heart attack symptoms, says Noel Bairey Merz, MD, director of the Barbara Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai Medical Center.
Other women might not have chest pain at all, and instead experience less obvious symptoms such as fatigue, indigestion, heartburn, nausea, vomiting, problems breathing, or pain in the back, neck, jaw, or throat.
Because these symptoms could also be attributed to many other health conditions, they’re easily overlooked, says Dr. Bairey Merz. Ignoring these symptoms is dangerous. Call 911 or get to the hospital for diagnosis and treatment.
Chest pain only in a certain position
“Pain that hurts more if you’re in a certain position is more likely due to a muscle pain,” says Dr. Khandwalla. “But it can be related to inflammation of the lining of the heart called the pericardium.”
The pericardium is a thin sac surrounding the heart that holds it in place. With pericarditis, the sac becomes inflamed. The cause is unknown, but it could be due to viral, bacterial, or fungal infections, chest injury, heart surgery, or an autoimmune disorder.
Lying down may seem to make it worse, but sitting up and leaning forward often eases the pain. Other symptoms include feeling tired and weak, coughing, trouble breathing, pain when swallowing, or a pounding heartbeat.
Your doctor will specifically listen for the pericardium rubbing against the outer layer of your heart. Treatment may include pain medicines, anti-inflammatory drugs, or antibiotics. See your doctor for a proper diagnosis. But if your symptoms more closely resemble those of a heart attack, then call 911.
Chest pain that hurts to the touch
“Pain that is reproducible by pressing on your chest is likely due to inflammation of the chest wall or muscle joints,” says Dr. Khandwalla. Some conditions cause you to feel tender or hurt when you touch the right side of your chest.
Costochondritis affects the cartilage that connects a rib to the breastbone. The causes are unknown, but this kind of chest pain is often seen with arthritis, trauma to the chest wall (something heavy hitting your chest), bacterial infections, and excessive coughing from a respiratory infection.
Costochondritis usually improves on its own, but you may need to call your doctor if the pain doesn’t get better. They may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) for pain or corticosteroid injections for pain and swelling.
You might have muscle pain in your chest from lifting weights or hoisting something heavy and twisting your body. Chest pain can also be a symptom of shingles, a painful blistering condition caused by reactivation of the same virus that causes chickenpox.
If the pain doesn’t subside after home treatments such as rest and pain relievers, see your doctor.
Chest pain that hurts when you’re coughing a lot
Excessive coughing from the common cold, pneumonia, or an inflamed lung condition gives the chest, back, and abdomen muscles quite a workout during coughing fits.
Pneumonia is an infection that inflames your lungs’ air sacs, filling them with fluid or pus. Symptoms include fever, chills, trouble breathing, and lots of coughing. All that coughing makes your chest hurt when you take a deep breath.
Coughing helps your body remove mucus, but your doctor may recommend a cough suppressant so you can get some rest. Your doctor may suggest NSAIDs for pain and possibly prescribe antibiotics, depending on the type of pneumonia you have.
Pleurisy in the chest wall occurs when there is swelling of the pleura, which is the thin lining around the chest cavity and lungs. It can be caused by bacterial and viral infections. Swelling causes the lungs to rub up against the chest, causing pain. Inhaling becomes painful, which forces quick and shallow breathing, causing more discomfort.
On the side where the pain is, the chest muscles move less than those on the other side. Treatments include NSAIDs to help relieve chest pain, and if the infections stem from bacteria, antibiotics are necessary. To help you sleep easier, your doctor may prescribe cough medicine for the dry cough that comes with pleurisy.
Chest pain so intense you can’t catch a breath
A pulmonary embolism is a blood clot that gets into the lung’s blood vessels, preventing the normal blood flow in that area. The blockages increase pressure back on the right side of the heart, making the heart work harder.
Sometimes pulmonary embolisms, which are rare, don’t have symptoms. But when a lung can’t cope with the clot, symptoms are intense and literally leave you breathless. That’s because the blood clot is irritating the lining around the lung, causing shallow breathing and a feeling that you can’t breathe deeply. And when you try to catch your breath, it is painful in the chest.
Lightheadedness and coughing up blood are other trademark symptoms. (A collapsed lung can also cause chest pain that worsens when you breathe or cough, and shortness of breath.) These symptoms suggest a medical emergency that warrants a 911 call.
Chest pain that feels like you’re tearing something
The aorta is the largest blood vessel in the body that is connected to the heart, so if something is amiss, it is a critical and potentially life-threatening matter.
“Any type of right-side chest pain that feels like a sharp, severe, tearing sensation that radiates to your back could indicate an aorta dissection, which is a tear in your aorta,” says Dr. Khandwalla.
Although it’s rare, other signs of aortic dissection include shortness of breath, rapid heartbeat, and even in some cases, stroke symptoms, which include face drooping, slurred speech, and arm weakness. “This is a medical emergency, and you should call 911 if you have these symptoms,” says Dr. Khandwalla.
When to see a doctor
Check in with your doctor if your right-side chest pain:
- Lasts just a few seconds
- Occurs only if you’re in a certain position
- Doesn’t seem to change or isn’t affected by exercise, or even gets better with exercise
- Can be reproduced by pressing on your chest
Go to the emergency room if your right-side chest pain:
- Occurs or increases in intensity with exertion and improves with rest
- Is associated with shortness of breath, sweating, lightheadedness, swelling of legs, or palpitations
- Starts in the chest, but then radiates to the jaw or shoulder
- Makes you pass out
- Feels like a tearing sensation that radiates to the back
- Raj Khandwalla, MD, cardiologist and director of Digital Therapeutics in the Smidt Heart Institute at Cedars-Sinai
- Ankur Kalra, MD, cardiologist, Cleveland Clinic in Akron, Ohio.
- Noel Bairey Merz, MD, cardiologist, director of the Barbara Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai
- Cedars-Sinai: “Pericarditis”
- Cedars-Sinai: “Chest Wall Infections”
- Stat Pearls: “Costochondritis”
- The Society for Cardiovascular Angiography and Interventions: "Aortic Dissection: A Rare, Dangerous Condition That Can Mimic a Heart Attack"
- Cedars-Sinai: “Pleurisy”
- American Lung Association: “Pneumonia Symptoms and Diagnosis”
- Johns Hopkins: “Pleurisy”
- American Thoracic Society: “Pulmonary Embolism”