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Rising in the a.m. feeling like you’ve been skewered in the chest is not the morning experience any of us hope for. Waking up with chest pain usually feels like a sharp or dull pain on either side of your chest. It can also (literally) take your breath away.

Once your chest pain disappears, you might decide to move on with your day and forget about it. Do 👏 not 👏 do 👏 that. Various health conditions can cause chest pain, and some may be a serious problem. It’s just not something to ignore, folks.

If your chest pain wake-up call lasts longer than a few minutes, something more serious is definitely up. Get to the emergency room stat.

Here’s what you need to know sooner rather than later about why you’re waking up with chest pain. Plus, treatment options that are available.

1. Heart attack

When it comes to chest pain at any time, a heart attack is usually the first alarm your mind sounds. A heart attack can start with mild pain on the left side of the chest that can built up gradually, or suddenly.

Essentially heart attacks happen when the heart muscle can’t get enough oxygen-rich blood and is damaged as a result. A blocked or ruptured coronary artery, or sometimes a blood clot, is usually the culprit.

Other symptoms include:

  • a sensation of pressure, tightness or squeezing in the centre of your chest
  • pain that travels from your chest to your arms, jaw, neck, back, or abdomen
  • feeling lightheaded or dizzy
  • sweating
  • shortness of breath
  • feeling or being sick
  • an overwhelming sense of anxiety
  • coughing or wheezing

Get to the emergency room

Heart attacks are no joke. If your chest pain lasts longer than a few minutes you need to hightail to the emergency room.

2. Pericarditis (aka inflamed heart tissue)

If the pericardium (basically two thin layers of heart tissue) becomes inflamed, it can cause a sharp stabbing pain on the left side or center of the chest. You can also have pain in one or both shoulders, and it might feel worse when you breathe or lie down.

3. Angina (aka reduced blood flow to heart)

Pain caused by angina is usually felt in the left side of the chest and can feel dull, tight, or heavy (it can also be a sharp stabbing pain). The pain may also move to your left arm, neck, jaw, or back. Stress or physical exertion can set off the pain, and it usually stops after you rest.

Angina can be a symptom of coronary microvascular disease (MVD), which is more common in women.

4. Myocarditis (aka inflammation of the heart wall)

Myocarditis chest pain usually hits on the left side of the chest and is caused by inflammation of the muscular layer of the heart wall. This can lead to abnormal heartbeat, chest pain, and trouble breathing.

In extreme cases, it can cause blood clots leading to a heart attack or stroke, and even heart failure (take care of your tickers, folks).

5. Cardiomyopathy (aka heart muscle disease)

Cardiomyopathy is a disease that affects the heart muscle and is usually felt on the left side of the chest (if you have symptoms at all).

Other symptoms include:

  • shortness of breath
  • dizziness
  • heart palpitations
  • swelling of the ankles, feet, legs, hands, or abdomen

1. Heartburn

Waking up with chest pain may also be heartburn trying to get you to reach for some Pepto.

Heartburn can strike when you lie down at night or after eating, potentially leading to some a.m. pain on the right side of the chest. Heartburn is usually caused by acid reflux, which is when that pesky stomach acid moves up your throat.

Other symptoms include:

  • a burning sensation in your throat
  • difficulty swallowing
  • feeling like food is stuck in your throat
  • an acidic taste in the back of your throat

2. Gallstones

Gallstones and gallbladder attacks can cause pain on the upper right side of the abdomen, which can extend to your chest.

Gallbladder attacks can happen when gallstones block the bile duct or tube of the gallbladder. This bile helps break up fats in food, and an attack usually occurs after eating, but can strike at any time.

3. Dysphagia (aka swallowing disorder)

A swallowing disorder, dysphagia affects the top of the throat or further down the esophagus, making it difficult and painful to swallow. This can also lead to chest pain.

4. Pancreatitis (aka an inflamed pancreas)

Chest pain isn’t a direct symptom of pancreatitis, but it can cause pain in the upper abdomen that can extend to your back and lead to chest discomfort.

Pancreatitis is an inflammation of the pancreas, and happens when the digestive enzymes start working while they’re still in your pancreas. This irritates your pancreas’ cells, and causes it to become inflamed.

Other symptoms include:

  • fever
  • nausea
  • rapid pulse
  • pain that becomes worse after eating

1. Cold or respiratory virus

The common cold or a respiratory virus like the flu can lead to chest pain. Constant hacking and coughing can make the chest feel sore.

Other signs you might be sick from a virus include:

  • fever
  • achy muscles
  • runny nose
  • headache
  • fatigue

2. Pneumonia

This is a painful condition caused by an infection in one or both of your lungs. It makes you cough and can cause pain on either side of the chest, which may also come when you breathe. If left untreated, pneumonia can be fatal.

Other symptoms include:

  • difficulty breathing
  • fever
  • chills
  • sweating
  • shaking
  • vomiting
  • diarrhea

3. Pleurisy

Pleurisy occurs when the membrane lining the outside of the lungs and inner side of your chest cavity, aka the pleura, becomes inflamed.

It can cause pain on either side of your chest when you breathe, as well as pain in your shoulders and back. The chest pain can get worse with coughing, sneezing, or laughing, and cause shortness of breath.

4.Collapsed lung

Also known as pneumothorax, a collapsed lung can cause a sudden, sharp chest pain. You can feel this on either side of your chest. This can be the result of untreated pneumonia, lung disease, ruptured air blisters, or ventilator use.

Get to an emergency room

More severe lung conditions needs hospital treatment ASAP and can be fatal.

1. Anxiety and panic attacks

Anxiety can cause chest pain on either side of the chest. A common reason for anxiety-related chest pain is a panic attack. This can feel similar to a heart attack, but it won’t actually kill you (even if it really feels like it).

Other symptoms of a panic attack include:

  • shortness of breath
  • dizziness
  • sweating
  • shaking
  • nausea
  • fainting

1. Pulled or strained muscles

Muscle strain in the chest region can be caused by injury or overuse of the body. It is one of the most common causes of chest pain.

It usually happens because of intense upper body activity. Chest pain can also come from pulling a muscle in the chest or between the ribs. It is not life-threatening and can be felt anywhere in the chest area.

2. Injury

Chest pain can also be from an injury that tears the chest muscle. This can also result in fractures, causing the following symptoms:

  • chest pain that gets worse with coughing
  • shortness of breath
  • swelling
  • bruising
  • tenderness

3. Hiatal hernia

A hiatal hernia is when the upper part of your stomach pushes through the large muscle between your abdomen and chest. It can cause both chest pain and abdominal pain.

How to treat heart-related chest pain

To treat heart-related chest pain, your doctor may prescribe you some medications that open partially closed arteries, clot-busting meds, or blood thinners.

In more extreme cases, your doctor may also suggest surgery to repair the arteries or use a catheter to check on your heart.

By inserting a catheter into an artery or vein in your groin, neck, or arm until it reaches your heart, your doc can run tests and use an X-ray to see how the vessels and chambers of the heart are doing.

How to treat digestive-related chest pain

For heartburn, you are often prescribed antacids or other medications to keep the acid from coming up from your stomach.

If something is going on with the gallbladder, surgery can remove gallstones from the bladder or you may need your gallbladder removed completely (don’t worry, you don’t actually need it!).

How to treat respiratory-related chest pain

Usually a viral infection is to blame for any respiratory-related chest pain. In that case there might not be a treatment available besides lots of rest and drinking plenty of fluids.

If something is seriously wrong like pleurisy, pneumonia, or a collapsed lung, get to the doctor ASAP.

How to treat mental health-related chest pain

The best thing you can do is go to your doctor to talk about your options. Chest pain is only a symptom of the mental health issues you’re facing, and the mental health issues need to be treated directly.

Your doc may suggest anxiety medication to stop the physical symptoms, or cognitive behavioural therapy to manage your anxiety attacks.

How to treat injury-related chest pain

Massages and over-the-counter (OTC) pain relievers can help ease the pain from a muscle strain or pull. In most causes, it is cured with OTC pain relievers and rest.

If you have a severe muscle tear, you will need to visit a doctor and may need surgery. A hernia will also require medical attention. A doctor may monitor your hernia over time to see if it improves or you will need to get surgery.

Though chest pain can be completely harmless, it can also be a sign of something more serious.

You should see a doctor if you have frequent chest pain that comes and goes, or if you have chest pain that goes away quickly but you are still worried. If you feel like you need to get checked out, do it. It’s better to play it safe!

Emergency treatment

You need to call 911 and get emergency treatment at the hospital immediately if you have the following symptoms:

  • the pain lasts longer than a few minutes (15 minutes is way too long)
  • the pain moves to your arms, back, neck or jaw
  • your chest feels tight (or heavy)
  • you have a shortness of breath
  • you’re struggling to breathe
  • you’re sweating
  • you’re feeling sick

If you wake up with chest pain, it’s important not to panic. Chest pain can be caused by a variety of reasons and it may not be life threatening.

If the pain doesn’t go away after a few minutes or is long-lasting, get to the doc ASAP. Also, keep an eye out for other symptoms and share them with your doctor.

While chest pain can be caused by a relatively minor problem, it could also be caused by something more serious, such as a heart attack or underlying condition that’s life-threatening and needs to be treated immediately.

When in doubt, get checked out.