Positional chest pain can be due to a variety of causes including heart problems, says Pilar Stevens-Cohen, MD, FACC, Department of Cardiology, South Nassau Communities Hospital.

Positional chest pain isn’t always caused by acid reflux or costochondritis.

“Typically, chest pain associated with deep inspiration [inhaling] or lying flat may be indicative of pericarditis or an inflammation in the lining of the heart,” says Dr. Stevens-Cohen.

“Patients usually get relief with sitting up or forward. The sitting forward allows the lining of the heart (layers) to separate and provides relief.”

The esophagus is right behind the sternum. “Esophageal spasms or GERD may be some GI reasons for having positional chest pain,” continues Dr. Stevens-Cohen. “GERD may increase at night and cause pain.”

Avoid eating fewer than three hours before bedtime to see if this relieves GERD (acid reflux) related chest pain.

“Musculoskeletal (chondritis) is also positional and can be reproduced by touching the affected area.” This kind of chest pain can hurt quite a bit.

“Pleurisy-inflammation in the lining of the lung can also cause positional pain. Localized inflammation.” This worsens with coughing and inhaling.

Dr. Stevens-Cohen is board certified in cardiology, nuclear cardiology, echocardiography and internal medicine.
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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