Women can experience chest pain due to several conditions, including lung, heart, and gastrointestinal diseases. Chest pain needs proper diagnosis and careful supervision, in order to determine its cause. Some of the factors responsible for chest pain in women are mentioned in this article.
Chest pain is often interpreted as the sign of an impending heart attack, but it is not necessarily true, especially for women. Women experiencing chest pain are usually examined for coronary heart diseases. The general belief that ‘chest pain is only related to the heart’ can make the entire process of diagnosing chest pain quite difficult.
Chest cavity contains ribs, muscles, skin, lung, pleura, trachea, aorta, esophagus, and heart. Problems in any of these parts may be the reason behind the chest pain.
In this article, we have grouped the different chest pain causes into 3 major categories – heart problems, lung diseases, and gastrointestinal problems.
Angina – Angina or angina pectoris is one of the most common causes of chest pain in both men and women. It occurs due to the reduced supply of blood and oxygen to the heart. This usually results from a blockage or spasm of the coronary arteries. Symptoms of angina include, tightness, heaviness, pain or a squeezing sensation in the chest, nausea, anxiety, dizziness, and sweating. The chest pain experienced due to angina can radiate to the arms, neck, shoulders, and the back as well.
Myocarditis – It is a condition where inflammation is present in the middle layer of the heart wall called myocardium. This inflammation usually results from a viral infection, and can produce symptoms like chest pain, along with abnormal heartbeat, fever, headache, body ache, joint pain, shortness of breath, and swelling of the legs, ankles, and feet.
Pericarditis – Pericardium is the sac-like membrane found around the heart, and pericarditis refers to the inflammation of its tissues. This condition usually produces a sudden, sharp pain in the chest, which can radiate to the neck and upper shoulder. The pain often worsens while deep breathing, swallowing, coughing, and also when lying down.
Myocardial Infarction – It is commonly known as ‘heart attack’, and is caused by a sudden reduction or blockage in the supply of blood to the heart. A squeezing pain or sensation of pressure and fullness in the chest is the most common symptom of a heart attack. The pain can sometimes radiate to the left arm, shoulder, back, and the jaw as well, and last for a few minutes. Shortness of breath, nausea, vomiting, sweating, and fainting are some other symptoms of an impending heart attack.
Apart from these, a few other heart-related diseases like valvular heart disease, mitral valve prolapse, rheumatic heart disease, mitral stenosis, hypertrophic cardiomyopathy, and coronary artery dissection can cause chest pain in both men and women.
The most common gastrointestinal problem that can cause chest pain or discomfort is acid reflux or gastroesophageal reflux disease (GERD). This condition is characterized by the regurgitation of stomach content and acid back to the esophagus, which produces a sour or acidic taste in the mouth, and a burning sensation in the chest. Women are more susceptible to this condition during pregnancy due to hormonal changes and a growing fetus. Other risk factors include smoking, obesity, and consumption of spicy and fatty foods.
Peptic Ulcer is another common problem of the gastrointestinal tract, which can cause burning pain anywhere from the navel up to the breastbone. Inflammation of the pancreas or pancreatitis can also lead to chest pain. Other gastrointestinal problems associated with chest pain include, hiatal hernia, gallbladder problems, esophageal rupture, esophageal hypersensitivity and esophageal contraction disorder. Gallbladder problems usually causes pain in the right side of the chest.
Pleurisy – Pleurisy, also known as pleuritis, refers to the inflammation of the pleura, the double membrane lining found around the lungs. It can be caused by viral infections, tuberculosis, pneumonia, and pulmonary embolism. The chest pain produced by this condition is usually very sharp and can be felt while inhaling and exhaling. The pain is often worsened by sneezing and coughing.
Pulmonary Embolism – Pulmonary embolism is caused by the presence of blood clots in the major blood vessels that carry blood to the lungs. A person suffering from this condition can experience chest pain, along with sudden shortness of breath and productive cough with blood-tinged sputum.
Pneumonia and Pneumothorax – Pneumonia refers to lung inflammation caused by bacterial, viral, fungal or parasitic infections. Pneumonia causes fever with chills, cough, headache, muscle pain, fatigue, and chest pain that is worsened by deep breathing. Pneumothorax, on the other hand, is caused when air leaks into the gap between the lung and the chest wall, mainly due to chest injury. This causes the lung to collapse, which can produce shortness of breath and chest pain that is sharp and sudden.
Sometimes, chest pain can be caused by problems associated with bones, muscles, and nerves as well. For example, rib injury and muscle strain can cause chest pain in many individuals. Liver diseases like, hepatitis can cause chest pain on the lower right side of the ribs. Diseases like shingles, asthma, and pulmonary hypertension (high blood pressure inside the pulmonary arteries) can also have an association with chest pain.
Women before menopause are less likely to have heart diseases, as a high level of estrogen helps maintain the level of good HDL cholesterol, and thus helps prevent atherosclerosis (narrowing of arteries). However, this does not mean that the possibility of heart attack is totally excluded. It only signifies that the risk of suffering from heart diseases is lower in women before menopause, as compared to men. After menopause, as the level of estrogen decreases over time, women are equally likely to develop coronary heart diseases.
The symptoms of a heart attack in women can be quite different from those experienced by men. Chest pain is generally considered to be ‘hallmark’ symptom of an impending heart attack. However, some women might not even have pain in the chest during a heart attack. Some may experience a number of subtle and hard-to-recognize symptoms like:
- Shortness of breath
- Heartburn, indigestion, and a discomfort in the upper abdomen
- Unusual fatigue
- Sleep disturbances
- Back pain
- Cold sweat
- Clammy skin
- Pain in the arm, neck, and jaw
Some of these symptoms can be present for several days before experiencing an actual heart attack.
- Chest pain that is sharp, and lasts only for a few seconds is usually not associated with a heart attack.
- Chest pain associated with the heart usually occurs gradually, and lasts for a few minutes (at least 5 minutes), and then subsides or results in a heart attack.
- A pain in the chest that radiates to the left arm, shoulder, neck, jaw, and also to the fingertips can be associated with heart attacks.
- Chest pain lasting for several hours is usually not associated with heart attacks.
- Chest pain, which is recurrent in nature, and induced by exertion and then relieved by rest, can be related to heart attacks.
- Chest pain worsened by movements, coughing, sneezing or deep breathing is usually not a symptom of heart attacks. Likewise, pain in the chest, intensified by the application of pressure is normally not associated with heart attacks.
- Chest pain, accompanied by shortness of breath, nausea and vomiting, sweating, dizziness, clammy skin and pain in the arm, shoulder, neck, and jaw could indicate an impending heart attack.
Chest pain caused by a heart attack warrants immediate medical intervention. Consulting a health care practitioner is important, if you have any doubt regarding your chest pain, or when the pain is unbearable and/or not improving at all with changes in diet and lifestyle. So, be sure to call your health care practitioner, whenever you experience:
- An intense pain or tightness and squeezing sensation in the chest.
- Pain that is quite severe or that does not go away with rest.
- Chest pain accompanied by other aforementioned heart attack symptoms.