‘Is the pain on the right side of my chest a heart attack symptom?’ is a common query on Google. The short answer is this — it need not be; only a medical expert can confirm. Most people tend to associate a cardiac emergency only with pain in their left chest. But multiple conditions can cause pain in the right side of the chest. Experts point out that it could be an indication of a serious underlying condition unless it is ruled out by a medical expert.
“Pain in any part of the chest should not be ignored. Chest pain on the left side might be more prominent and alarming, but you should not take chest pain on the right side lightly either,” says Dr Rana Serbjeet Singh, consultant cardiologist, Manipal Hospitals, Salt Lake, Kolkata. He adds that simple tests such as ECG should be done to rule out any underlying heart condition.
What causes pain on the right side of the chest?
The common reasons for pain in the right chest are heartburn and cardiac inflammation. Doctors say that chest pain on the right side is mostly a ‘referred pain’, with the actual source of pain being either in the lungs or abdominal organs.
“There are interconnected nerves running across tissues in the chest wall, lungs, diaphragm and the lining of the abdomen,” adds Dr Singh to explain the reason for the referred pain in the chest region.
A common symptom of both heartburn and heart attack is chest pain. But unlike the latter, heartburn is comparatively non-fatal. It occurs when stomach acid flows back to the esophagus, causing a burning sensation. “The pain caused due to acid reflux usually starts from the upper area of the stomach. However, it can radiate on the right side of the chest,” says Dr Singh. Though some food could trigger heartburn, don’t ignore it if it’s accompanied by excessive sweating and difficulty in breathing, he adds.
2. Muscle strain
“Strained chest muscle can lead to right side chest pain,” says Dr Singh.
Dr Singh explains, “The intercostal muscles (muscles between two ribs) become inflamed, causing more pain during movement.” Sportspersons, especially weightlifters are at higher risk of muscle-related chest pain.
3. Cardiac inflammation
Two cardiac inflammation variants, pericarditis and myocardium (myocarditis) could lead to pain in your right chest.
“Myocarditis mimics the symptoms of heart attack,” says Dr Singh. It occurs due to inflammation of the middle heart muscle layer and leads to chest pain or shortness of breath. Myocarditis is usually due to viral or fungal infection, drug abuse or autoimmune conditions causing pain in your entire chest including the right side.
4. Heart attack
Most signs of a heart attack occur on the left side and they increase while walking or engaging in physical activities; they subside during rest. Pain related to heart attacks are mostly on the left side, but it can radiate to the right side, explains Dr Srinivasa Prasad B V, consultant, interventional cardiologist, Fortis Hospital, Bengaluru.
Costochondritis is another common cause of right-side chest pain. Dr Singh says that costochondritis occurs due to inflammation of the cartilage that connects the rib to the breastbone. “The pain will worsen with movement and deep breathing,” adds Dr Singh.
6. Pulmonary embolism
Pulmonary embolism usually occurs due to a clot in the pulmonary artery that supplies blood to the lungs. Dr Prasad says, “When a blood clot obstructs a pulmonary artery, it can partially or completely stop the blood flow to the lungs leading to excess strain on the surrounding lung tissue causing pain in the chest region.”
7. Lung collapse or pneumothorax
It’s a condition that occurs when air enters the space between the lungs and the chest wall, leading to lung collapse or pneumothorax. Dr Prasad says that the accumulation of air can irritate the pleura (lining around the lungs) causing pain in the chest. Dr Singh says that the chest pain can be felt while breathing either on the left or right side of the chest.
8. Pleurisy or pleuritis
The lungs are covered with a thin layer of tissue (called pleura). Dr Singh says, “When there is an infection in the lung, the pleura gets affected and becomes inflamed causing chest pain.”
Dr Singh says that gallbladder issues could lead to pain on the right side of the chest. He further adds that the inflammation caused by cholecystitis (gallstone obstructs a bile duct causing bile build-up in the gallbladder) can cause chest pain on the upper right abdomen that can radiate to the right side of the chest.
Dr Singh says, “Viral infection such as shingles can also cause chest pain on the right side.” If shingles affect nerves in the chest, it can cause chest pain.
A study shows that people with shingles are twice as likely to have a heart attack or stroke.
11. Panic attack
People can experience chest pain or discomfort due to anxiety or panic attacks, says Dr Prasad. He adds that this pain could either be on the left or right side.