Sudden Sharp Pain in Right Chest: Causes and When to Seek Help

Sudden sharp pain in the right chest without any apparent cause?

Hello, I suddenly experienced sharp pain in my right chest after coughing.
It hurts when I inhale, but it's bearable.
I couldn't find any information online, and over-the-counter pain medication has provided some relief.
The pain feels more like a stabbing sensation rather than a dull ache, and it is located throughout my right chest.
This is the third occurrence; the first time was nine months ago, and it came on suddenly, making it impossible to move.
I still don't know the cause.
If I go to the hospital for an examination, which department should I visit, and what tests should I undergo? Additionally, I have been coughing for four months.
I previously visited a large hospital, and they diagnosed me with bronchitis.
After taking the prescribed medication for two weeks, I felt some improvement, but I still cough every night and have trouble sleeping due to an itchy throat, possibly with some phlegm.
What should I do about this? I also have a history of nasal allergies, which are not severe but still bothersome.

Lion, 10~19 year old female. Ask Date: 2016/01/15

Dr. Zhang Ziyan reply Pulmonology

Hello Lion, if chest pain persists, please seek medical attention as soon as possible to confirm with imaging studies.
For detailed information, please consult your treating physician.
Changhua Hospital cares about you.

Reply Date: 2016/01/15

More Info

Sudden sharp pain in the chest, especially when associated with coughing, can be concerning and warrants careful evaluation. Given your description of the pain being sharp and localized to the right side of your chest, it is essential to consider several potential causes.
1. Musculoskeletal Issues: The pain could be related to muscle strain or irritation of the intercostal muscles, which are located between the ribs. This type of pain often worsens with movement or deep breathing and can be exacerbated by coughing. If you have been coughing for an extended period, it is possible that the muscles in your chest have become strained.

2. Pleural Irritation: The lining of the lungs (pleura) can become irritated due to infections or inflammation, leading to sharp pain, especially during deep breaths or coughing. Conditions such as pleuritis or pleurisy can cause this type of pain.

3. Pulmonary Issues: Given your history of bronchitis and ongoing cough, it is also important to consider potential pulmonary issues. Conditions such as pneumonia or a pulmonary embolism (a blood clot in the lungs) can present with sharp chest pain and coughing. While these conditions are less common, they can be serious and require immediate medical attention.

4. Gastroesophageal Reflux Disease (GERD): Sometimes, sharp chest pain can be related to acid reflux, where stomach acid irritates the esophagus. This can mimic cardiac pain and may be accompanied by a cough, especially at night.

5. Cardiac Issues: Although less likely given your age and description, it is crucial to rule out any cardiac conditions, especially if the pain is severe or associated with other symptoms like shortness of breath, sweating, or radiating pain to the arm or jaw.

When to Seek Help
Given that this is the third episode of similar pain and considering your ongoing cough, it is advisable to seek medical attention. You should visit a healthcare provider, preferably a primary care physician or a pulmonologist, who specializes in respiratory issues. They can perform a thorough evaluation, including:
- Physical Examination: A detailed examination to assess your respiratory function and any signs of distress.

- Chest X-ray: This can help rule out pneumonia, pleural effusion, or other lung-related issues.

- CT Scan: If there is a suspicion of a pulmonary embolism or other serious conditions, a CT scan may be warranted.

- Pulmonary Function Tests: These tests can assess your lung function and help diagnose any underlying respiratory issues.

- Blood Tests: To check for signs of infection or other systemic issues.

Managing Your Cough
For your persistent cough, especially if it has lasted four months, it is essential to address the underlying cause. Since you have a history of bronchitis and nasal allergies, consider the following:
- Allergy Management: If you have nasal allergies, managing them with antihistamines or nasal corticosteroids may help reduce post-nasal drip, which can contribute to coughing.

- Cough Suppressants: Over-the-counter cough medications may provide temporary relief, but it is crucial to address the underlying cause of the cough.

- Hydration: Staying well-hydrated can help thin mucus and soothe your throat.

- Avoid Irritants: Stay away from smoke, strong odors, and other irritants that may exacerbate your cough.

In summary, while your symptoms may be related to musculoskeletal issues or ongoing bronchitis, it is essential to seek medical evaluation to rule out more serious conditions. Early intervention can help manage your symptoms effectively and prevent complications.

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