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Pain in Right Side of Chest

Last reviewed by Dr. Raj MD on January 12th, 2022.

If you are experiencing pain on the right side of the chest, you should know that this is one kind of pain that should not be ignored. Even though many people believe that this pain is a sign of a heart attack, this is not usually the case. There are many other conditions that can lead to such problems, especially in the elderly population. The pain can either be caused by cardiovascular problems or it can radiate from other parts of the body, such as the gallbladder or the liver. Identifying the correct cause of the pain will guide one towards the adequate treatment.

Symptoms of Pain in Right Side of Chest

These are the most common symptoms that can appear at the same time with the right side chest pain:

  • Burning sensation at the level of the chest
  • Acid reflux and heartburn
  • Difficult swallowing (dysphagia)
  • Difficult breathing (dyspnea)
  • Nausea and vomiting
  • Jaundice.

Causes of Right Sided Chest Pain

These are the most common causes that can lead to pain on the right side of the chest:

  • Indigestion
    • Right side chest pain + heartburn – main symptoms
    • Aggravating factors – smoking, alcohol abuse, coffee, stress
  • Viral infection
    • One of the symptoms of flu can be the pain on the right side of the chest
    • Physical movement, deep breathing and coughing can make the pain more intense (aggravating factors)
  • Gastritis
    • Main characteristic – inflammation of the stomach lining
    • Risk factors – fasting, alcohol abuse
    • Abdominal pain often encountered in patients suffering from gastritis
    • Pain radiate to the right side of the chest
  • Inflammation of the pleura
    • Pleura – thin membrane that covers the lungs
    • The inflammation of the pleura can lead to pain on the right side of the chest
    • Aggravating factors include coughing and deep breathing
  • Lung disease
    • Most common:
      • Asthma
      • Bronchitis
      • Emphysema
      • Infection
    • Pneumothorax
      • Partial lung collapse
      • After in injury, trauma caused by falling or car accidents
    • Pneumonia
      • Infection at the level of the lungs, causing them to become filled with fluid
    • Pulmonary embolism
      • Blood clot that travels into the lungs
      • The patient can have difficulties breathing, the heart rate being increased and the pleura inflamed
      • May cause shock and high-running fever
      • Can be a life-threatening condition
    • Pulmonary hypertension
      • Abnormally high blood pressure at the level of the lung arteries
      • Pain can be mistaken for the one caused by angina
  • Cardiovascular disease
    • Most common:
      • Heart attack
      • Cardiomyopathy
    • Angina
      • Right side chest pain + burning and pressure sensation
      • May be confused with indigestion
    • Aortic dissection
      • Small tear developed at the level of the aorta
      • Often seen as a result of an accident/high blood pressure patients (life-threatening condition)
      • Surgical intervention required
    • Coronary artery dissection
      • Wear and tear of the coronary artery
      • Sudden onset of severe right sided chest pain
      • The pain can radiate to other parts of the body, such as the back, abdomen or neck (ripping or tearing sensation)
  • Gallbladder disease
    • Inflammation of the gallbladder → pain on the right side of the chest
    • Pain more obvious after eating fatty foods (harder to digest)
    • Pain also present in the situation that gallstones are blocked at the level of the bile duct
  • Disorders of the digestive tract
    • Esophagus involvement → chest tightening → pain on the right side of the chest
    • Esophageal hypersensitivity → exposure to acid/pressure changes → right side chest pain
    • Esophageal rupture → abrupt and severe right sided chest pain + vomiting
    • Peptic ulcer
      • Painful sores on the mucosal lining of the stomach
      • Risk factors include: NSAIDs (aspirin, paracetamol), smoking, alcohol abuse
  • Disorders of the liver (hepatitis, liver inflammation)
    • Pain on the right side of the chest, radiating towards the back or the shoulder
  • Injury or trauma
    • Recent injury → minor rib displacement/neck injury → right side chest pain
  • Pancreatic disorders (+dysfunction)
    • Inflammation of the pancreas → abdominal swelling → radiated pain to the right side of the chest
  • GERD (Gastroesophageal reflux)
    • Stomach contents go back into the esophagus, leading to heartburn
    • Esophagus irritation → right side chest pain
  • Thoracic tumor
    • Lung tumor → right side chest pain
    • Similar type of pain can be caused by tumors developing in the surrounding area of the lungs
  • Medication (as side-effect)
    • Antacid → chronic use → right side chest pain (side-effect)
  • Excessive physical effort
    • Strenuous physical activity → use of chest muscles → right side chest pain
    • Pain → muscle soreness → movement aggravates the pain
  • Stress
    • Stress → exacerbation of disorders involving the digestive system → right side chest pain
  • Muscle pulling
    • Muscle/ligament pull → right side chest pain
  • Food blockage
    • Esophagus blockage → food/beverage → congestion → right side chest pain
  • Other causes
    • Fibromyalgia
    • Costochondritis.

Is the Right Side Chest Pain an Emergency?

The right side chest pain can be considered an emergency, especially in the situation in which there is no known physical activity to have caused it. It is important to understand that there are certain symptoms that can draw attention to the fact that the right side chest pain is not just a simple pain. For example, if you experience sudden pressure or tightness at the level of the chest, you should seek out emergency medical assistance. The same goes in the situation that the chest pain radiates to other parts of the body, such as the arm, back or jaw.

If the right side chest pain is accompanied by difficult breathing, this definitely represents an emergency. Other symptoms that qualify for an emergency include: profuse sweating (hyperhidrosis), paleness of the skin, confusion, increased heart rate and breathing, nausea and feeling lightheaded. The reduced heart rate or blood pressure should also represent a cause for alarm. The same goes for high-running fever, difficulty swallowing and extreme chest pain that do not go away with symptomatic treatment.

Treatment for Pain in the Right Side of Chest

From the start, it should be mentioned that the pain on the right side of the chest is not a condition on its own, but rather a symptom. In order to relieve the pain and other associated symptoms, such as inflammation, one can consider taking anti-inflammatory medication. The only situation in which this symptomatic medication is not recommended is when the person is suffering from gastritis or peptic ulcer. In such cases, it is the treatment consists of antacid medication (liquid or oral form). The medication has to be taken in the precise dosage recommended by the doctor, otherwise it will lead to similar problems.

Apart from the symptoms, the treatment also has to address the underlying condition. In case of an infection, powerful antibiotics might be administered, along with natural probiotics (so as to maintain a healthy intestinal flora). Apart from that, in the situation that the condition represents an emergency, such as the aortic dissection, the surgical intervention is the only form of treatment. The treatment should never be administered without identifying the exact cause, otherwise it can cause even problems.

Prevention

In some situations, it is possible to prevent the pain on the right side of the chest, by keeping the triggering factors under control. You can reduce the risk of heart disease by keeping a healthy diet and performing physical exercise. As for the intense physical activity, you should always follow the recommendations of the doctor in regard to how much physical effort you are allowed to perform.

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