Right Chest Pain: Possible Causes and When to Seek Help

Chest pain

Recently, I've been experiencing pain in my right chest, especially when I lower my shoulder; it hurts the most then.
I can't really pinpoint the source of the pain when I touch it.
It's strange because I don't recall any sports injuries.
What could be the possible causes? Could it be a tumor? Wishing you peace and happiness.

Long, 20~29 year old female. Ask Date: 2005/04/27

Dr. Zhao Chongliang reply Internal Medicine

Chest pain can be caused by serious conditions such as acute myocardial infarction, aortic dissection, pulmonary embolism, lung cancer, esophageal cancer, rib or intercostal tumors, or pneumothorax.
It can also result from less severe issues like chest wall pain (including menstrual breast tenderness and intercostal neuralgia), visceral pain unrelated to the heart and lungs (such as pain from the esophagus and surrounding tissues), or even normal psychological factors leading to phantom chest pain, such as worries about a partner's infidelity, relationship issues, work stress, or anxiety.

However, considering your pain is on the right side (excluding myocardial infarction), you are a young male (without menstrual concerns), have no family history of hypertension (excluding aortic dissection), no substance abuse (excluding septic pulmonary embolism), no autoimmune diseases or prolonged bed rest (excluding pulmonary embolism due to another coagulation factor abnormality), and you are not tall and thin with non-persistent symptoms (excluding pneumothorax), and you have no ulcers or gastroesophageal reflux (excluding pain from the esophagus and surrounding tissues), a chest X-ray should be sufficient.
If there are no abnormalities, it is likely chest wall pain or phantom chest pain, and there is no need for concern.

However, remember to avoid smoking, as it can lead to chronic cough or increase the risk of lung cancer and esophageal cancer, both of which can cause chest pain.
Additionally, tumors occasionally found on the ribs or intercostal spaces that compress the intercostal nerves are unlikely to occur at your age.

Reply Date: 2005/04/27

More Info

Right chest pain can be concerning, and it’s important to understand the potential causes and when to seek medical help. Chest pain can arise from various sources, including musculoskeletal issues, gastrointestinal problems, and cardiac conditions. Given your description of the pain being more pronounced when lowering your shoulder and the inability to pinpoint a specific source, let’s explore some possible causes.

1. Musculoskeletal Issues: One of the most common causes of localized chest pain, especially when it worsens with certain movements or positions, is musculoskeletal strain. This could be due to muscle strain, costochondritis (inflammation of the cartilage connecting the ribs to the sternum), or even a pinched nerve in the neck or upper back. If you have been engaging in activities that involve repetitive motion or poor posture, these could contribute to muscle tension and pain.

2. Gastrointestinal Causes: Sometimes, chest pain can be related to gastrointestinal issues such as acid reflux or esophageal spasms. These conditions can cause discomfort that may mimic heart-related pain. If you notice that the pain is accompanied by symptoms like heartburn, regurgitation, or difficulty swallowing, it may be worth considering these gastrointestinal causes.

3. Cardiac Concerns: While musculoskeletal and gastrointestinal issues are more common, it’s crucial to rule out cardiac problems, especially if the pain is new or accompanied by other symptoms such as shortness of breath, sweating, nausea, or pain radiating to the arm, jaw, or back. Conditions like angina or even a heart attack can present with chest pain, and they require immediate medical attention.

4. Anxiety and Stress: Psychological factors can also manifest as physical symptoms, including chest pain. Anxiety and panic attacks can lead to muscle tension and hyperventilation, which may cause discomfort in the chest area.

Given that you mentioned the pain is particularly noticeable when you lower your shoulder, it may suggest a musculoskeletal origin. However, it is essential to approach this with caution. If the pain persists, worsens, or is accompanied by any alarming symptoms, you should seek medical evaluation promptly. A healthcare provider may perform a physical examination, and if necessary, imaging studies like X-rays or MRIs to assess for any underlying issues.

In summary, while there are several potential causes for your right chest pain, the most appropriate course of action is to monitor your symptoms closely. If you experience any concerning symptoms or if the pain does not improve, do not hesitate to consult a healthcare professional for a thorough evaluation. Early diagnosis and treatment can help address the underlying cause and alleviate your discomfort. Remember, it’s always better to err on the side of caution when it comes to chest pain.

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