Causes of Chest Pain - Pulmonary Problems

Asthma, Bronchitis, Pneumonia, Pleuritis

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Among the many non-cardiac problems that can produce chest pain are a variety of disorders associated with the lungs. Several pulmonary problems can produce — in addition to other symptoms — significant chest pain. These include disorders of the airways such as asthma or bronchitis, infection or inflammation of the lungs themselves ( pneumonia ), or inflammation of the lining of the lungs (which is called pleuritis or pleurisy).

Fortunately, when chest pain is being cause by a pulmonary condition, it is usually not too difficult for a doctor to make the correct diagnosis. So this kind of chest pain is not very often confused with chest pain due to angina or a myocardial infarction.

It is worth keeping in mind that the heart is not the only critical organ in the chest. Any of these pulmonary conditions are serious medical problems that need a doctor’s attention.

Chest Discomfort From Asthma

Asthma is a chronic disease in which the airways periodically become inflamed or irritated, causing the muscles of the airways to constrict, leading to airway obstruction. “Attacks” of asthma can be triggered by exposure to airborne irritants, exposure to cold air, to exercise — or often, to nothing in particular that can be identified. During an attack, the airways become narrowed, and it becomes difficult to expel air from the lungs.

In addition to severe shortness of breath, wheezing and cough, the asthma sufferer may experience significant chest tightness, or chest pain.

This asthma-induced chest tightness is caused by the excessive muscular effort that is needed to expel air through the constricted airways, which may lead to muscle fatigue and strain.

Just as with any other skeletal muscles, the chest muscles hurt when they are overused.

Once the episode of asthma is adequately treated, the chest tightness goes away — though there may remain some residual soreness for a day or two.

These severe asthma attacks can be greatly reduced or eliminated with adequate treatment.

Chest Discomfort From Bronchitis

Like asthma, bronchitis is also a condition characterized by obstruction of the airways, although with bronchitis the obstruction is due to inflammation and swelling of the lining of the airways and an accumulation of mucus, rather than to muscular constriction. (People with chronic bronchitis, however, often also have a component of asthma.) 

Bronchitis may be an acute condition (most often associated with an infection), or it may be chronic — a form of chronic obstructive pulmonary disease.

Because it is also disorder of airway obstruction, the chest discomfort associated with bronchitis is very similar to that caused by asthma.

Chest Pain From Pneumonia

Pneumonia is an inflammation of the lung tissue itself, usually caused by an infection. Pneumonia can also produce chest pain. The pain is usually caused either by muscle strain from excessive coughing, or by an associated inflammation of the lining of the lungs (pleurisy).

Chest Pain From Pleurisy

Pleurisy (or pleuritis) is an inflammation of the lining of the lungs. It can be caused by a number of conditions including a viral or bacterial infection; autoimmune disorders such as lupus or rheumatoid arthritis; medications including procainamide, hydrazine and isoniazid; pneumothorax; chest surgery; and cancer.

The pain caused by pleurisy is usually quite characteristic. Because the lining of the lungs is irritated, anything that stretches the lung lining causes pain. That “anything” includes breathing.

So “pleuritic pain” is chest pain that is caused by taking a breath, coughing, or moving the chest.

The pain may be localized to one area of the chest (or shoulder), or it may be generalized.

Pleuritic pain is sometimes quite similar to the pain of pericarditis, and indeed with autoimmune diseases ( including Dressler’s syndrome ), people can develop both pericarditis and pleurisy (a condition called pleuropericarditis).

Once the pleuritic inflammation is adequately treated, the pleuritic pain resolves.

A Word From Verywell

Chest pain or discomfort caused by pulmonary problems are generally characteristic enough not to be confused by doctors with the pain of a heart attack.

But any of these lung conditions is itself a significant medical issue that needs to be evaluated and treated by a physician.

Sources:

Bösner S, Becker A, Haasenritter J, et al. Chest Pain In Primary Care: Epidemiology And Pre-Work-Up Probabilities. Eur J Gen Pract 2009; 15:141.

Global Strategy For The Diagnosis, Management, And Prevention Of Chronic Obstructive Pulmonary Disease: Revised 2011. Global Initiative for Chronic Obstructive Lung Disease (GOLD). www.goldcopd.org (Accessed onSeptember 10, 2012).

National Asthma Education and Prevention Program: Expert Panel Report Iii: Guidelines For The Diagnosis And Management Of Asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on December 04, 2014).

Verdon F, Herzig L, Burnand B, et al. Chest Pain In Daily Practice: Occurrence, Causes And Management. Swiss Med Wkly 2008; 138:340.

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