What are the odds that if you uexplainably feel pain in both your back and your chest that it’s a heart attack?

Perhaps you’ve read that back pain can signal an oncoming heart attack, or occur with the actual heart attack.

Maybe you’ve heard that both back and chest pain can occur with a heart attack.

However, does pain in the back, plus chest, automatically mean that there is something wrong with your heart?

“Not necessarily, but possibly,” says Robert M. Davidson, MD, a cardiologist with SignatureMD.

“If it is associated with exertion or stress, it might be heart related. If it is affected by movement or position, it is more likely to be muscular-skeletal.”

A condition that can cause back and chest pain, upon body position or movement, is costochondritis, an injury to the cartilage in the ribcage. This can hurt pretty bad, but it is benign.

Dr. Davidson continues, “Severe back pain, sometimes radiating to the chest, can be a sign of a leaking or ruptured aortic aneurysm, which is a medical emergency, and should be considered if someone has risk factors such as high blood pressure, older age, or known arteriosclerosis. The type of pain associated with this is often described as tearing.”

A tear in the inner lining of the aorta. Shutterstock

People who have survived a ruptured aortic aneurysm, or aortic dissection, have also described the feeling as “ripping.” An aneurysm is an abnormally dilated or enlarged section of an artery.

Usually there are no symptoms until the aneurysm tears. Most aortic aneurysms are discovered by accident via imaging for another issue.

Most non-leaking or non-rupturing aneurysms don’t cause symptoms, but when they do, they may consist of chest, back, neck and jaw pain, a hoarse voice, abnormal stethoscope sounds, coughing and shortness of breath.

An esophageal spasm is another possible cause of chest pain that radiates to the back (including between the shoulder blades).

This is a benign (though sometimes very painful) non-cardiac issue and has no known cause.

Keep in mind that you can have both a musculoskeletal problem and a heart problem — both causing chest and back pain!

Dr. Davidson is with the Division of Cardiology at Cedars-Sinai Medical Center, Los Angeles, and has been practicing for 30+ years. Areas of specialty include coronary artery disease, heart attack and palpitations.
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.  
Top image: Shutterstock/ArtFamily
Source: webmd.com/digestive-disorders/tc/esophageal-spasm-topic-overview