Chest Pain in Women: Exploring the Cardiac & Non-cardiac Causes

 

Key Takeaways

• Chest pain is often associated with heart disease, but there are numerous non-cardiac causes of chest pain in women.
• Common heart-related causes include heart attacks, myocarditis, angina, aortic aneurysms, and cardiomyopathy. These conditions may manifest differently in women, with symptoms like radiating pain, shortness of breath, and fatigue.
• Lung-related causes comprise pulmonary hypertension, pneumonia, pulmonary embolism, tuberculosis, and collapsed lung. Each of these can lead to chest pain, especially during breathing.
• Gastrointestinal and digestive issues such as GERD and gallbladder inflammation can mimic cardiac symptoms, causing chest pain.
• Mental health factors like anxiety, panic attacks, and Broken Heart Syndrome can also result in non-cardiac chest pain in women.
• Regardless of the cause, it's vital to take chest pain in women seriously and seek immediate medical attention to prevent potential complications. Early intervention can lead to better health outcomes.

A prevalent belief held by many people is that chest pain in women is primarily associated with heart disease. While this is not entirely without merit, it only tells half the story. Besides cardiac issues, multiple factors can lead to chest pain in women.

Most Common Female Chest Pain Causes

1. Heart-related causes of chest pain in women

Some of the heart problems that can cause chest pain in women include the following:

 a) Heart attack

Chest pain is assumed to be the most prominent sign of a heart attack. While chest pain is indeed a notable symptom, there are additional indicators such as breathlessness, as well as pain radiating to the jaw, back, neck, and arms. Along with this, a person is also likely to experience lightheadedness and shortness of breath. Other signs of heart attacks in women include extreme fatigue, vomiting and nausea. 

b) Myocarditis

It can be defined as the inflammation of heart tissue that is present in the middle layer of the heart wall. The primary causes of myocarditis in women include heart pain in women, irregular heartbeat and shortness of breath. 

c) Angina

As per Dr. Nagraj Desai (2023), lack of blood supply to the heart muscle often causes chest pain and this is referred to as angina pectoris. However, in the case of women, they feel the pain at a distant location from the source of origin such as arms, neck, jaws and back. Apart from this, females also experience shortness of breath, nausea, and light-headedness. 

d) Aortic aneurysm and dissection

In this condition, there occurs a tear or separation of the inner layers of the main aorta causing blood to build up in the artery. The crucial sign of the condition is a radiating pain from the chest to the upper back that is often described as a tearing or ripping sensation. A study analysed the records of patients suffering from Spontaneous coronary artery dissection (SCAD) in the Mayo Clinic SCAD Registry enrolled from 2012 to 2016 (Tweet et al., 2017). Based on the analysis, the authors divulged that some of the women experienced chest pain shortly before the start of their menstrual period, typically occurring 1 to 2 days before the onset of bleeding.

 e) Cardiomyopathy

It is a condition in which the heart faces difficulty in pumping blood to the rest of the body and can lead to heart failure. Some of the symptoms of cardiomyopathy include chest pain, changes in heart rhythm, shortness of breath, dizziness, lightheadedness, fainting, swelling in the feet, ankles, legs, and abdomen

2) Lungs-related causes of chest pain in women

Just like in heart diseases, chest pain is the most common symptom of pulmonary diseases. Some of the common lung problems include the following:

a) Pulmonary hypertension

In the study conducted by Madam et al. (2018), pulmonary hypertension is an underdiagnosed cause of chest 

b) Pneumonia

It is a common acute respiratory infection that presents with symptoms like cough, breathlessness, fatigue, sputum production and chest pain (Torres et al., 2021). Therefore, one of the underlying female chest pain causes could be pneumonia. 

c) Pulmonary embolism

this is a condition in which blood clots get trapped in the artery that supplies blood to the lungs. In such a situation, the women experiencing it could feel chest pain, especially during breathing. 

d) Tuberculosis

Another major cause of chest pain could be the prevalence of tuberculosis. When a patient suffers from pulmonary tuberculosis at that time she is most likely to experience symptoms such as chest pain, cough with mucus, fatigue and others. 

e) Collapsed lung 

A woman suffering from pneumothorax also known as collapsed lung is most likely to have chest pain that could radiate to the shoulder. However, some people may not display any symptoms. 

3) Gastrointestinal and digestion-related causes of chest pain in women

Apart from heart-related chest pain causes, there are some other potential non-heart-related causes of chest pain in women. Some of the most common female chest pain causes associated with the digestive tract include the following:

a) Gastroesophageal reflux disease (GERD)

It is a condition in which stomach acid moves backwards from the stomach to the oesophagus (food pipe). People suffering from GERD often complain about chest pain along with heartburn. 

b) Gallbladder inflammation (cholecystitis)

In certain cases, acute cholecystitis can mimic cardiac symptoms such as chest pain and bradycardia (Daliparty et al., 2021). Thus, the prevalence of chest pain in women could also be an indication of cholecystitis or inflamed gallbladder.

4) Mental health-related causes of chest pain in women

a) Anxiety and panic attacks

Another major cause of non-cardiac chest pain is high anxiety and panic attacks. During this time, the female chest pain location is on the left side of the chest. Unlike heart pain in women during a heart attack, it is a mild stabbing pain that starts suddenly. 

b) Broken Heart Syndrome

It is a condition in which a person feels the symptoms of a heart attack and chest pain is one of them. This condition is triggered by stressful situations like the death of someone a person loves, abuse, serious illness and many more. This is one of the female chest pain causes that is triggered by the release of stress hormones that temporarily affect the ability of the heart to pump. Clinically, the condition is termed as either stress-induced cardiomyopathy or takotsubo cardiomyopathy. 

In conclusion, whether chest pain originates from cardiac or non-cardiac factors, it's crucial to treat chest pain in women with utmost seriousness and immediate medical assistance should be sought. This proactive approach can help prevent avoidable complications and ensure better overall health outcomes.

References 

1. Dr. Desai, N., 2023. What is Angina Pectoris? DocTube. Available at: (Accessed: 30 October 2023).
2. Madam, N., Mosleh, W., Punnanithinont, N., Carmona-Rubio, A., Said, Z.H. and Sharma, U.C., 2018. Pulmonary Arterial Enlargement is Associated With Acute Chest Pain in Patients Without Obstructive Coronary Artery Disease. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 12, p.1179548418758021.
3. Torres, A., Cilloniz, C., Niederman, M.S., Menendez, R., Chalmers, J.D., Wunderink, R.G. and van der Poll, T., 2021. Pneumonia. Nature Reviews Disease Primers, 7(1), pp.1-28.
4. Daliparty, V.M., Amoozgar, B., Razzeto, A., Ehsanullah, S.U.M. and Rehman, F., 2021. Cholecystitis masquerading as cardiac chest pain: a case report. The American Journal of Case Reports, 22, pp.e932078-1.
5. Tweet, M.S., Codsi, E., Best, P.J., Gulati, R., Rose, C.H. and Hayes, S.N., 2017. Menstrual chest pain in women with history of spontaneous coronary artery dissection. Journal of the American College of Cardiology, 70(18), pp.2308-2309.

FAQ

 

Is chest pain in women always a sign of a heart attack?

 

   

No, chest pain in women could be due to many other causes such as stress, Gastroesophageal reflux disease, Pulmonary hypertension and many more. Thus, it should not always be considered as one of the signs of heart attack in women.

 

 

Which is the female chest pain location that should not be ignored?

 

   

Irrespective of the location of the chest pain, it should not be ignored and a doctor should be consulted immediately.

 

 

Can menopause cause chest pain?

 

   

Scientifically, no link has been found between chest pain and menopause in women.