Pain in upper left side of chest above breast

Heart disease not the only reason for that feeling of angina

Pain in upper left side of chest above breast

Although chest pain is often—and rightfully— associated with heart disease, other medical problems can be causes of chest pain. Angina—feelings of pressure, heaviness, tightness. or pain in the chest—occurs when plaque in the coronary arteries partially blocks blood flow and the heart muscle isn't getting enough oxygen and nutrients. (You can learn more about angina in the Harvard Special Health Report Diseases of the Heart: A compendium of common heart condition and the latest treatments.) Yet the heart isn't the only organ in the upper abdomen, and chest pain may be due to conditions affecting the esophagus, lungs, gall bladder, or stomach.

Digestive causes of chest pain

When chest pain—particularly pain in the lower chest— is triggered by a meal, it is likely to emanate from the digestive system, rather than from the heart, and can be due to the following:

Acid reflux or heartburn. When acid from the stomach flows up into the esophagus, it can cause a burning sensation in the chest reminiscent of a feeling of angina  or often mistaken for a heart attack.

Esophageal spasm.  Sudden, forceful contractions of the esophagus, the muscular tube between the mouth and the stomach, can be painful. These spasms can also trap food in the esophagus and prevent it from passing into the stomach.

Gallbladder disease. A sudden pain that often occurs 30 minutes after you have eaten may be a sign of gallstones. Gallbladder pain is usually felt just below the breastbone and may extend to the right arm or between the shoulder blades. It occurs as the gallbladder contracts in an effort to pump bile around the gallstones that are blocking its passage to the liver.

Inflammatory causes of chest pain

Tissues in the chest cavity can become inflamed due to injury, infection, or autoimmune conditions, in which the body's immune cells attack its own tissues. Common inflammatory causes of chest pain include the following:

Costochondritis. This condition, an inflammation in the chest wall between the ribs and the breastbone, can trigger a stabbing, aching pain that's often mistaken for a heart attack. Costochondritis is commonly caused by trauma or overuse injuries, often during contact sports, or it may accompany arthritis.

Pericarditis is an inflammation of the pericardium, a protective, double-layered sac surrounding the heart. It has many different possible causes, including a virus or other infection, certain illnesses, an injury to the chest, radiation therapy for cancer, or a reaction to medications. The classic symptom of pericarditis is a sharp, stabbing pain in the center or left side of the chest that worsens when you take a deep breath or lie down. The pain results from the irritated layers of the sac rubbing together.

The following lung conditions often produce chest pain that may feel like angina. 

Pneumonia can cause shortness of breath and sharp pains that intensify with a deep breath. Unlike angina, it is likely to be accompanied by other symptoms, like fever, chills, or coughing.

Pulmonary embolism—a blood clot that has traveled into the vessels supplying the lungs—can cause chest pain. The pain is often accompanied by a fast or irregular heartbeat, sudden difficulty breathing, or feeling lightheaded or faint. Pulmonary embolisms can be life-threatening, so the symptoms warrant a call to 911.

Psychological causes of chest pain

Both anxiety and panic attack can cause symptoms very similar to angina. These attacks—which can occur out of the blue or in response to a stressful event—include chest pain along with shortness of breath, palpitations, and dizziness. The key difference is that the chest pain is usually fleeting, lasting only a moment or two.

What to do when you're uncertain

Any time you're uncertain about the source of chest pain that is recurrent or lasts for several days, you should talk to your clinician. However, if you have chest pain that is building in intensity, has lasted for several minutes, and isn't relieved by resting, you should get immediate medical attention.

Costochondritis is inflammation where your ribs join the bone in the middle of your chest (breastbone). It can cause sharp chest pain, especially when moving or breathing. It usually gets better on its own over time.

Check if you have costochondritis

Costochondritis may cause sharp pain in the front or side of your chest.

The pain may be worse when:

  • moving your upper body
  • lying down
  • breathing deeply
  • you press the middle of your chest

Urgent advice: Get help from NHS 111 if:

  • you think you have costochondritis

It is important to get chest pain checked to rule out other more serious conditions.

You can call 111 or get help from 111 online.

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
  • started with a shortness of breath, sweating, feeling sick 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.

Treatments for costochondritis

Costochondritis usually gets better on its own, over time. It can last for a few weeks to several months.

Painkillers that help with inflammation, like ibuprofen, may be recommended to help with the pain.

If you have very bad pain that does not get better over time, you may be offered a steroid injection to help reduce inflammation or local anaesthetic to ease the pain.

Causes of costochondritis

It is not always known what causes costochondritis, but it may be caused by:

  • an injury to your chest
  • repetitive upper body movements, like lifting
  • coughing a lot

Sometimes it may be caused by a problem with the joints in the back, or another underlying condition like fibromyalgia or rheumatoid arthritis.

It can also be caused by an infection.

Page last reviewed: 26 July 2022
Next review due: 26 July 2025

What does pain above your left breast mean?

Chest pain on the left side above a female breast may be due to heartburn, a panic attack, gallbladder disease, gallstones, peptic ulcer and pneumonia.

What organ is above your left breast?

Organs like the stomach, heart, lungs, ribs, colon, spleen, and pancreas lie in the upper left region of our bodies. Therefore, if the area under your left breast hurts, it could signify problems or issues in these organs.

How do you know if chest pain is muscular or heart?

The pain of a heart attack differs from that of a strained chest muscle. A heart attack may cause a dull pain or an uncomfortable feeling of pressure in the chest. Usually, the pain begins in the center of the chest, and it may radiate outward to one or both arms, the back, neck, jaw, or stomach.

What causes chest pain above breast?

The most common causes of pleuritic chest pain are bacterial or viral infections, pulmonary embolism, and pneumothorax. Other less common causes include rheumatoid arthritis, lupus, and cancer. Pneumonia or lung abscess. These lung infections can cause pleuritic and other types of chest pain, such as a deep chest ache.