Right-Side Chest Pain: Pay Attention, But Don’t Panic

Have you ever felt a sudden sharp pain or dull ache on the right side of your chest that caught you off guard? It's natural to worry about your heart when you feel chest pain, but there are many other possible reasons for discomfort on the right side. It could be from strained muscles, issues with your lungs, or other unexpected causes. Let's explore what might be causing you this discomfort and when you should see a doctor about it.

In some cases, this type of chest pain is accompanied by other symptoms such as:

• A feeling of tightness in the chest
• Pain in the right side of the chest when breathing
• Discomfort that intensifies with movement or coughing

Right-sided chest pain: When to be concerned and when to ignore it

Discomfort or sharp pain in the right side of the chest is referred to as right-sided chest pain. This can happen for different reasons, like problems with muscles and bones in your chest, breathing difficulties, issues with your stomach or digestion, or even problems with your heart. While we often associate left-sided chest pain with heart problems, pain in the right side shouldn't be ignored either, as it can also indicate a serious condition. Depending on what's causing the discomfort, the symptoms can differ.

Possible causes of right-sided chest pain

The underlying causes of right-sided chest pain include issues with muscles, digestion, breathing, and the heart.

A) Muscle and bone issues

• Muscle strain:
  Injured muscles in your chest or upper back that hurt more when you move or take deep breaths. It can also cause a sharp, stabbing pain, hurts more when you twist or touch the area
• Rib fractures:
  A broken or cracked rib can cause sharp, stabbing pain that intensifies with breathing, coughing, or movement. Rib fractures are usually caused by direct trauma, such as a fall or accident. In severe cases, they can also affect breathing, so a medical assessment is important.
• Costochondritis:
  This is the inflammation of the cartilage that connects your ribs to the breastbone (sternum). It can cause pain that mimics a heart attack, particularly when you breathe deeply, cough, or move your upper body. Though it’s usually harmless, it can be quite uncomfortable and may take weeks to settle.

B) Stomach and digestive problems

• Acid Reflux (GERD):
  Stomach acid travels up into your oesophagus (food pipe), leading to a burning sensation in your right chest. This discomfort may feel like heartburn, indigestion, or bloating, and the intensity or nature of the pain can vary depending on its underlying cause.
• Gallstones:
  Gallstones form in the gallbladder and can block bile flow, leading to cramp-like pain in the upper right side of the chest or abdomen. The pain often occurs after eating fatty foods and may radiate to your back or right shoulder.
• Indigestion and bloating:
  Overeating, eating too quickly, or consuming rich foods can cause pressure and discomfort in your upper abdomen that sometimes radiates to the right side of your chest.

C) Breathing issues

• Pleurisy: Inflammation of the lining around your lungs, causing sharp pain that gets worse when you breathe deeply. It can also lead to a sharp pricking pain that varies with breathing.

• Pneumonia: A bacterial or viral infection of the lungs can lead to pain on one side of the chest, along with symptoms such as fever, cough, shortness of breath, and fatigue.

• Pulmonary embolism: A blood clot in the lungs can cause sudden, sharp pain that may worsen when breathing deeply. It’s often accompanied by breathlessness and requires immediate medical attention.

D) Heart-related concerns

• Angina:
  Reduced blood flow to your heart, sometimes causing pain in the right side of your chest. This pain often feels like squeezing, crushing, or pressure and may occur during physical activity or periods of stress, though it can also appear at rest.
• Heart attack:
  While chest pain from a heart attack is usually central or left-sided, it can sometimes be felt on the right. Symptoms may include tightness, shortness of breath, nausea, or pain radiating to the arm, jaw, or back. This is a medical emergency and requires urgent care.

E) Other possible causes

• Stress and anxiety:
  Severe stress or anxiety can cause muscle tension and lead to chest discomfort. Panic attacks, in particular, may cause intense chest pain, shortness of breath, sweating, and a racing heart, mimicking heart-related issues.
  
  
• Shingles (Herpes zoster):
  A viral infection that affects the nerves, shingles causes a painful rash or blisters on one side of the chest or back. The pain may begin days before the rash appears and can be sharp, burning, or tingling.
  
  
• Breast issues:
  In women, infections, cysts, or inflammation in breast tissue can lead to localised pain or tenderness on the right side of the chest, often mistaken for deeper chest discomfort.
  
  
• Liver or diaphragm problems:
  Conditions affecting the liver, such as hepatitis or fatty liver disease, or irritation of the diaphragm, can sometimes cause dull pain on the right side of the chest or upper abdomen.

What can I do at home to treat/avoid right-sided chest pain?

Mild right-sided chest pain is often caused by muscle strain, indigestion, or mild inflammation rather than heart-related issues. To ease discomfort at home, try applying a warm compress to relax tense muscles and improve blood flow. Gentle stretching or light movement can also help relieve muscle stiffness if the pain is due to strain. Eating smaller, balanced meals and avoiding spicy or fatty foods can prevent indigestion-related chest pain. Staying hydrated, practising deep breathing or relaxation exercises, and maintaining good posture can further reduce discomfort. However, if the pain is severe, persistent, or accompanied by symptoms such as shortness of breath, dizziness, or sweating, seek immediate medical attention.

Key factors to consider in treating right-sided chest pain

• How bad is the pain? Doctors will usually ask you to rate your pain on a scale from 1-10.
• Where is the pain: Chest pain that’s only in one spot might be less serious. Discomfort extending to your arms, neck, or jaw may originate from your heart.
• How long does it last? Pain that goes away quickly is less likely to be a heart problem.
• What makes it worse or better: Does it hurt more when you move or breathe? Does it go away when you rest? Does the pain change in relation to food intake?

Other symptoms to look out for

• Sweating, vomiting: Could indicate a serious heart condition
• Coughing up blood: Very rare, but a sign of a lung problem, like a clot
• Feeling dizzy or passing out: Signals that your heart or lungs might be in trouble
• Bloated feeling, nausea, or vomiting: Could be from your digestive system

Your medical history and risks

• Past chest pain: Your doctor will want to know if this has happened before and what was found.
• Health risks: Factors such as smoking, elevated blood pressure, high cholesterol, diabetes, or a family history of heart conditions can play a role.

Finding relief

The treatment for pain in the right side of the chest under the ribs depends on the underlying cause. Dr Toms Jacob, an experienced medical officer working in the Health Services Department of Kerala, says, "All cases of chest pain, even if it's right-sided, should be evaluated by a doctor at the earliest opportunity. The treatment strategy depends on the underlying cause. Our priority is to rule out life-threatening conditions such as heart attacks or blood clots in the lung and provide appropriate and timely treatment."

When should you contact the doctor?

You should seek immediate medical attention if you experience any of the following signs along with right-sided chest pain:

• Sudden onset of severe chest pain
• Crushing pain in your chest
• Persistent pain or pressure in your chest that does not go away
• Chest pain accompanied by shortness of breath
• Discomfort that extends to your jaw or shoulder
• Chest pain along with dizziness or weakness.
• Loss of consciousness
• Other concerning symptoms like a high fever or coughing up blood.

If you have chest pain that lasts longer than five minutes and does not improve with rest or medication, it's crucial to seek immediate medical help. These signs might point to a severe underlying problem that needs immediate assessment and care.

Better safe than sorry

A variety of factors — some serious and some not — could cause right-sided chest pain. It’s important to pay attention to how it feels, when it happens, and any other symptoms you might have. If you’re ever unsure or if the pain is severe or getting worse, don’t hesitate to seek medical help. Quick action can make a big difference in getting the right treatment and feeling better soon.

Frequently Asked Questions

1) What does right-sided chest pain mean?

Right-sided chest pain is discomfort or pain that specifically occurs on the right side of the chest. It can stem from various causes, including issues with muscles, bones, lungs, digestion, or even the heart. While it's less commonly associated with heart problems compared to left-side chest pain, it should still be taken seriously as it can indicate serious conditions that may require medical attention.

2) How do I know if my chest pain is serious?

If you have the following symptoms, chest pain is considered serious:

• Sudden and intense onset: Chest pain that starts suddenly and intensely
• Crushing or heavy pressure: Feeling like a heavy weight on your chest
• Radiation: Pain spreading to your jaw, shoulder, arm, or back
• Breathing difficulty: Chest pain accompanied by trouble breathing
• Dizziness or weakness: Feeling faint or lightheaded
• Nausea or vomiting: Especially with chest pain
• Coughing up blood: A rare but serious symptom
• Should your chest pain continue, escalate during physical exertion, or not alleviate upon resting, it's critical to quickly seek medical assistance to identify the underlying issue and receive suitable care.

3) How do I know if my chest pain is muscular- or heart-related?

Heart-related chest pain, such as that from a heart attack, can often continue hurting even when you're at rest. On the other hand, muscular chest pain tends to be more noticeable when you move your chest or press on the area. If you're experiencing chest pain that persists, especially at rest, it's important to seek medical attention promptly to determine the cause.

4) What is non-cardiac right-sided chest pain?

Right-sided chest pain not related to the heart can stem from various causes, including musculoskeletal issues like muscle strains or rib fractures, gastrointestinal problems such as acid reflux or gallstones, respiratory conditions like pleurisy or pneumonia, as well as other factors like shingles or anxiety-related symptoms. It's important to seek medical attention for persistent or severe pain to accurately diagnose and treat the underlying cause.

5) Is right-sided chest pain okay?

Right-sided chest pain can have many causes, some serious and some not. It's important to get it checked out by a doctor to understand what's causing it and whether it needs treatment. Taking action early can help ensure your health and well-being.