A cardiologist explains eight conditions that can cause constant chest pain but no other symptoms.
What can possibly cause constant chest pain and no other symptoms?
The most common cause is angina, says Dr. Sameer Sayeed, a cardiologist at ColumbiaDoctors of Somers, NY.
Angina is chest pain as a result of coronary artery disease.
Dr. Sayeed explains, “If the pain is constant, there is likely a severe flow-limiting coronary artery lesion that is causing persistent inadequate blood flow and ischemia [impaired oxygen supply] to a portion of the heart, resulting in constant chest pain which will usually not abate unless medication is administered or percutaneous intervention as in a stent or angioplasty is performed.
“Or if enough time passes, that portion of the heart will either scar over and the pain will go away, or collateral circulation will develop and the pain will be relieved.”
Collateral circulation is when new coronary vessels develop and transport blood.
If you think you have angina, do NOT assume it will eventually scar over or collateral circulation will solve the problem. You may need a stent or even bypass surgery.
Other causes of constant chest pain without other symptoms:
Pericarditis—inflammation of the sac that surrounds the heart.
This “can cause a constant chest pain that is sometimes resolved with high dose NSAIDS or Colchicine, but sometimes is not relieved and can be constant until the inflammation of the pericardium subsides over time,” says Dr. Sayeed.
“Another cause of constant chest pain is musculoskeletal chest pain. This can be due to inflammation or soreness of the chest muscles themselves, similar to what occurs in other muscle groups of the body.
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“Or it can be due to inflammation of the joint between the ribs and breast bone, causing an arthritis type pain of these joints similar to other joints of the body, resulting in constant chest pain that may or may not be relieved by NSAIDS or other pain meds.”
This last condition goes by the name of costochondritis, and it’s hardly unheard of in the bodybuilding world.
“Another cause of chest pain that tends to be more common in women is nerve related and involves the nerve fibers innervating the chest and the heart,” says Dr. Sayeed.
“These can become oversensitive and cause severe chest pain that cannot be explained by most cardiac tests, as these people often have a normal angiogram and stress testing and no muscle or chest wall or rib-breast bone joint tenderness.
“They are often helped by a pain management specialist.”
More Causes Yet
Dr. Sayeed continues, “Other causes of constant chest pain can be hiatal hernia which is when the stomach herniates [enters] into the chest cavity.”
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The next condition shouldn’t be a surprise, what with all the TV ads about it: gastroesophageal reflux disease (GERD), “due to reflux of gastric acid into the esophagus, causing lower chest pain.”
Next on the list is an esophageal spasm. The esophagus is actually a muscle (though not skeletal muscle).
These spasms tend “to cause very painful constant chest pain.”
Finally, Dr. Sayeed says, “Certain lung conditions causing excessive coughing will also cause constant chest pain.”
Dr. Sayeed performs echocardiograms and stress tests at the Midtown Manhattan and Westchester offices at Columbia Doctors. He is also trained in cardiac CT imaging.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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