A cardiologist explains possible causes of left side chest pain when exhaling.

“Left sided chest pain that occurs with exhaling only is very rare,” says Donna P. Denier, MD, of The Cardiology Center with the Appalachian Regional Healthcare System.

“Usually pain that is related to inflammation of the lining of the heart or lungs (pericarditis or pleurisy) will occur with inspiration (inhaling), but it can happen with both (inhaling and exhaling) because it is worsened by any movement of the lining.”

Of course, pleurisy, which is inflammation of the lining of the lung, wouldn’t cause left side chest pain only when exhaling — but rather, both exhaling and inhaling.

“Asthma is a condition where exhaling can become difficult and there may be a sensation of pain on exhaling,” says Dr. Denier.

“Other things to consider are pulmonary embolism (blood clot), rib fracture, pneumonia [which can be only on the left side], spontaneous collapse of the lung or shingles (herpes zoster).”

A pulmonary embolism is likely to also present with difficulty breathing.

Risk Factors for a Blood Clot in Lung

Prolonged Bed Rest


Recent Orthopedic or Abdominal Surgery




Birth Control Pill Use






Recent Long Trip in an Airplane

If your rib is fractured, you’ll likely recall getting hit there or taking a hard fall.

If you’re healthy and fit, it’s not likely that your lung has suddenly collapsed, and shingles usually comes with additional symptoms.

Nevertheless, these above conditions can cause left side chest pain with each exhalation.

Can left sided chest pain only upon exhaling be related to heart disease?

Plaque buildup in artery. Shutterstock/Explode

“This type of pain (only on exhaling) is not likely to be from coronary artery disease because angina is not related to respiration but is more likely to be influenced by exertion,” explains Dr. Denier.

“Even though the heart is located slightly to the left side, pain related to the heart is most often substernal or right under the sternum, the bone in the middle of your chest.

“Heart pain can be on the left however, and heart pain that is associated with breathing is usually inflammatory in nature and called pericarditis.”

I’ve had left side chest “pain” upon only exhalation more than once, and it correlated to my gym workouts (I suspect involvement of the pectoralis fascia).

The “pain” was more like an ache, but was quite noticeable.

The last time this happened, I could make it disappear if I leaned forward in my chair — even a hard exhalation couldn’t bring it out.

But if I sat back in the chair and exhaled, it was there. By late evening, it was completely gone.

Chest pain from coronary heart disease is not influenced by a change of position or, as Dr. Denier says, respiration.

donna denier, md

Dr. Denier has been practicing medicine for over 15 years and is board certified by the American Board of Internal Medicine – Cardiovascular Disease.
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/Korawat photo shoot

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