Pain in middle left side of chest

Table of Contents Show

Signs and symptoms of pericarditis
Complications of pericarditis
Diagnosing pericarditis
Specialists involved
Medical history
Physical exam
Diagnostic tests
Immediate action required: Call 999 if:
Non-urgent advice: See a GP if:
Common causes of chest pain
Chest pain and heart problems
Why would my chest be hurting on the left side?
When should I worry about left side pain chest?
How do you know if left chest pain is heart related?

Signs and symptoms of pericarditis

A common symptom of acute pericarditis is a sharp, stabbing chest pain, usually coming on quickly. It's often is in the middle or left side of the chest, and there may be pain in one or both shoulders.

Sitting up and leaning forward tends to ease the pain, while lying down and breathing deep worsens it. Some people describe the pain as a dull ache or pressure in their chest.

The chest pain may feel like a heart attack. If you experience chest pain, call 911 right away because you may be having a heart attack.

Fever is another common symptom of acute pericarditis. Other symptoms are weakness, trouble breathing and coughing. Palpitations, which are feelings that your heart is skipping a beat, fluttering or beating too hard or too fast, may occur and can be a sign of deeper heart tissue involvement.

Chronic pericarditis often causes tiredness, coughing and shortness of breath. Chest pain is sometimes absent with this type of pericarditis. Severe cases of chronic pericarditis can lead to swelling in the stomach, feet, ankles and legs and hypotension (low blood pressure).

Complications of pericarditis

Two serious complications of pericarditis are cardiac tamponade and chronic constrictive pericarditis.

Cardiac tamponade happens if too much fluid collects in the sac, putting pressure on the heart. This prevents the heart from properly filling with blood, so less blood leaves the heart, causing a sharp drop in blood pressure. Untreated cardiac tamponade can be fatal.
Chronic constrictive pericarditis is a rare disease that takes time to develop. It leads to scar-like tissue forming throughout the sac around the heart. As the sac becomes stiff and unable to move properly, the scarred tissue starts to compress the heart and prevent it from functioning well.

Diagnosing pericarditis

A doctor diagnoses pericarditis based on your medical history, a physical exam and test results.

Specialists involved

Primary care doctors, such as a family doctor, internist or pediatrician, often diagnose and treat pericarditis. A cardiologist, pediatric cardiologist or infectious disease specialist may be involved, depending on the patient’s age and medical conditions.

Medical history

Your doctor may ask whether you have had:

A recent respiratory infection or flu-like illness
A recent heart attack or injury to your chest
Other medical conditions

If you have chest pain (angina), your doctor will ask you to describe how it feels, where it's located and whether it's worse when you lie down, breathe or cough.

Physical exam

When the pericardium is inflamed, the fluid between the sac's two layers of tissue increases. So your doctor will look for signs of excess fluid in your chest. A common sign is the pericardial rub. This is the sound of the pericardium rubbing against the outer layer of your heart. Your doctor will listen for this using a stethoscope.

Your doctor may hear other chest sounds that are signs of fluid in the pericardium (pericardial effusion) or the lungs (pleural effusion). Both are more severe problems related to pericarditis.

Diagnostic tests

Your doctor may recommend tests to diagnose your condition and its severity. The most common tests are:

EKG (electrocardiogram): This detects and records your heart's electrical activity, with certain EKG results suggesting pericarditis.
Chest X-ray: A chest X-ray takes pictures of the inside of the chest, including your heart, lungs and blood vessels. The pictures can show whether you have an enlarged heart, which can be a sign of excess fluid in your pericardium.
Echocardiography (PDF): This test uses sound waves to create pictures of your heart, showing its size and shape and how well it's working. It can show fluid build-up in the pericardium.
Cardiac CT (computed tomography): This X-ray takes a clear, detailed picture of your heart and pericardium and helps to rule out other causes of chest pain.
Cardiac MRI (magnetic resonance imaging): A cardiac MRI uses magnets and radio waves to form detailed pictures of your organs and tissues. It can show changes in the pericardium.
Your doctor also may recommend blood tests to find out if you've had a heart attack, the cause of your pericarditis and the extent of inflammation in your pericardium.

Learn more:

View an animation of angina

Most chest pain is not a sign of anything serious but you should get medical advice just in case. Get immediate medical help if you think you're having a heart attack.

Immediate action required: Call 999 if:

You have sudden chest pain that:

spreads to your arms, back, neck or jaw
makes your chest feel tight or heavy
also started with shortness of breath, sweating and feeling or being sick
lasts more than 15 minutes

You could be having a heart attack. Call 999 immediately as you need immediate treatment in hospital.

Non-urgent advice: See a GP if:

you have chest pain that comes and goes
you have chest pain that goes away quickly but you're still worried

It's important to get medical advice to make sure it's nothing serious.

Common causes of chest pain

Chest pain has many different causes. In most cases, chest pain is not caused by a heart problem.

Your symptoms might give you an idea of the cause. Don't self-diagnose – see a GP if you're worried.

Possible causes

Chest pain symptoms	Possible cause
Starts after eating, bringing up food or bitter tasting fluids, feeling full and bloated	heartburn or indigestion
Starts after chest injury or chest exercise, feels better when resting the muscle	chest sprain or strain
Triggered by worries or a stressful situation, heartbeat gets faster, sweating, dizziness	anxiety or panic attack
Gets worse when you breathe in and out, coughing up yellow or green mucus, high temperature	chest infection or pneumonia
Tingling feeling on skin, skin rash appears that turns into blisters	shingles

Chest pain and heart problems

The most common heart problems that cause chest pain include:

pericarditis – which usually causes a sudden, sharp, stabbing pain that gets worse when you breathe deeply or lie down
angina or a heart attack – which have similar symptoms but a heart attack is life-threatening

You're more likely to have heart problems if you're older or know you're at risk of coronary heart disease.

For example, if you:

smoke
are very overweight (obese)
have high blood pressure, diabetes or high cholesterol
have a history of heart attacks or angina in family members under 60 years old

Page last reviewed: 14 August 2020
Next review due: 14 August 2023

Why would my chest be hurting on the left side?

If a person is experiencing chest pain on the left side of their body, this could indicate a heart attack or other medical conditions, such as a lung problem or inflammation of the lining around a person's heart.

When should I worry about left side pain chest?

Call 911 if you have any of these symptoms along with chest pain: A sudden feeling of pressure, squeezing, tightness, or crushing under your breastbone. Chest pain that spreads to your jaw, left arm, or back. Sudden, sharp chest pain with shortness of breath, especially after a long period of inactivity.

Heart-related chest pain Pressure, fullness, burning or tightness in your chest. Crushing or searing pain that spreads to your back, neck, jaw, shoulders, and one or both arms. Pain that lasts more than a few minutes, gets worse with activity, goes away and comes back, or varies in intensity. Shortness of breath.