Chest Pain During Coughing: Possible Causes and Concerns

Q: Chest Pain During Coughing: Possible Causes and Concerns

Hello： As mentioned, although most of the symptoms are still consistent with myofascial pain syndrome, pneumothorax cannot be ruled out. <br>Please consult a pulmonologist for further evaluation.

Coughing with chest pain?

Hello Doctor: Two weeks ago, I choked on water and coughed quite forcefully.
I noticed that when I coughed hard, I experienced pain in my left chest (there is no pain when I am not coughing).
A few days later, I visited a pulmonologist and had an X-ray taken.
The doctor said there was no pneumothorax and did not mention any issues, so I didn't pay much attention to it and felt relieved.
However, two weeks later, which is today, I just choked on water again and coughed a bit forcefully, and I noticed that I still feel pain in my left chest when I cough.
Could you please tell me what possible conditions this might indicate? Thank you.

Xiao Ji, 30~39 year old female. Ask Date: 2017/08/29

Dr. Zhou Ziguang reply Pulmonology

Hello: As mentioned, although most of the symptoms are still consistent with myofascial pain syndrome, pneumothorax cannot be ruled out.
Please consult a pulmonologist for further evaluation.

Reply Date: 2017/08/29

More Info

Chest pain during coughing can be concerning, especially when it occurs after a forceful cough or aspiration, such as when you choke on water. There are several potential causes for this type of pain, and understanding them can help you determine whether further medical evaluation is necessary.

1. Muscle Strain: One of the most common causes of chest pain during coughing is muscle strain. When you cough forcefully, the muscles in your chest wall can become strained or overworked, leading to localized pain. This is often exacerbated by repeated coughing or sudden movements.

2. Costochondritis: This condition involves inflammation of the cartilage that connects the ribs to the sternum. It can cause sharp pain in the chest that may worsen with coughing, sneezing, or certain movements. Costochondritis is usually benign and can be managed with rest and anti-inflammatory medications.

3. Pleuritic Pain: If the pain is sharp and worsens with deep breaths or coughing, it may be related to pleuritis, which is inflammation of the pleura (the lining around the lungs). This can occur due to infections, such as pneumonia, or other inflammatory conditions.

4. Pulmonary Issues: While less common, certain pulmonary conditions can cause chest pain during coughing. For instance, pneumonia or bronchitis can lead to chest discomfort due to inflammation in the lungs. If you have a history of respiratory issues, such as asthma or chronic bronchitis, this could be a contributing factor.

5. Referred Pain: Sometimes, pain in the chest can be referred from other areas, such as the esophagus or even the heart. If you experience additional symptoms like shortness of breath, dizziness, or radiating pain to the arm or jaw, it is crucial to seek immediate medical attention, as these could indicate a more serious condition.

6. Underlying Conditions: Given your history of asthma and bronchial sensitivity, it’s possible that your airways are reacting to the forceful cough, leading to discomfort. Asthma can cause bronchospasm, which may contribute to chest pain during coughing.

In your case, since the pain is localized to the left side of your chest and occurs specifically during coughing, it may be more likely related to muscle strain or costochondritis. However, if the pain persists, worsens, or is accompanied by other concerning symptoms (such as difficulty breathing, fever, or significant changes in your health), it would be prudent to follow up with a healthcare provider for further evaluation.
Diagnostic imaging, such as a chest X-ray or CT scan, can help rule out any serious underlying conditions, especially if there are any signs of infection or structural abnormalities. Additionally, if you continue to experience recurrent episodes of coughing and pain, it may be beneficial to assess your asthma management plan to ensure that your airways are well-controlled.

In summary, while muscle strain or costochondritis are likely culprits for your chest pain during coughing, it’s essential to monitor your symptoms closely and consult a healthcare professional if there are any changes or concerns. Proper evaluation can help ensure that any underlying issues are addressed and managed appropriately.

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