Chest pain is a frequent reason for medical consultation. This can range from a minor nuisance to a disabling stitch. Different phenomena explain the discomfort in the thorax. Here are 17 common causes of chest pain on the right side.
The chest or thorax is the body region between the neck and the abdomen. It contains essential organs, such as the heart, lungs, and esophagus, as well as large vessels originating from the aorta and vena cava. The chest walls are made up of the ribs, thoracic spine, and sternum, as well as the intercostals, pectorals, and back muscles.
In general, chest pain can be caused by multiple pathologies, so it is essential to consider its characteristics and location. With this information, it is possible to have an initial diagnostic suspicion. A timely medical assessment is highly relevant to avoid potential complications.
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17 causes of chest pain on the right side
The causes of chest pain on the right side can be diverse, ranging from compromised bone and muscle structures to damage to the thoracic organs. In the same way, discomfort at this level can also reflect conditions that occur in other parts of the body. Some of the most common origins are the following:
1. Muscle Strain
Muscle strain is one of the most common reasons for chest pain. It usually occurs after strenuous physical activity at home, the park, or the gym. The discomfort is the result of the breakdown and regeneration of muscle fibers.
A study from the Chilean Journal of Radiology describes that sudden distension during eccentric contraction is the most frequent mechanism of muscle tear production. This is common in sports that involve sudden acceleration-deceleration or changes of direction.
The pectoralis major and minor muscles are usually the most affected in the thorax. The pain is described as a stitch or compression of the chest that improves with rest and intensifies with movement. In some cases, it is accompanied by swelling and limited motion of the arms.
This condition usually disappears on its own after 1 to 2 days. Professionals recommend rest, massages in the area, and the use of analgesic and anti-inflammatory drugs to relieve discomfort.
2. Direct blows and rib fractures
Trauma to the chest from falls or direct blows is a common cause of right-sided chest pain. In the case of traffic accidents, there may be vascular and nervous compromise and even internal organs.
The Moderate and vigorous blows are accompanied by pain, swelling, and redness of the affected area. Similarly, people can have bruises and difficulty moving their limbs.
To relieve pain, it is advisable to apply cold compresses for 10 to 20 minutes, 2 to 3 times daily. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful.
According to an Argentine Journal of Surgery investigation, rib fractures are the most frequent injury in thoracic trauma. The presence of intense pain that limits or stops breathing is common .
In addition, in rib fractures, there is tenderness and swelling. There may be lung involvement, respiratory distress, agitation, and loss of consciousness in severe cases.
The treatment of fractures is medical in its entirety. This is based on immobilization of the area, lung stabilization, repair of the bone defect, and pain medications. Some people require physical therapy to regain functionality.
3. Costochondritis
It is an inflammatory disorder of the chondrosternal joints responsible for joining the ribs with the sternum. This entity is also known as Tietze Syndrome. According to a study published in Correo Científico Médico, it is usually associated with redness in the painful area, inflammation, and a local increase in temperature.
The pain appears at the right or left chest level and extends to the center of the chest, back, and abdomen. It is generally throbbing and worsens with inspiration, coughing, and movement. In addition, palpation of the chondrosternal joints generates sharp and intense pain.
Medical treatment of costochondritis includes rest and the application of physical means, such as hot and cold compresses. Similarly, in acute cases, local infiltration with anesthetics can be performed.
4. Angina pectoris and myocardial infarction
Heart conditions are a prevalent cause of chest pain. They are common in the elderly, obese, and with excessive consumption of cigarettes, coffee, and alcohol. Angina pectoris and myocardial infarction are caused by heart muscle ischemia, the product of a reduction in blood and oxygen supply.
Chest pain of ischemic origin manifests as a feeling of oppression in the chest that extends to the neck and left shoulder. It is usually triggered by physical exertion and is relieved by rest. Depending on the severity of the condition, vasodilators or opioid analgesics can be used to alleviate pain.
In angina, the duration of pain is less than 15 minutes. On the other hand, a study in the journal Finally describes that myocardial infarction pain usually lasts for 20 minutes or more. Furthermore, it does not change with breathing or chest movements.
In women, the discomfort can appear on the right side of the chest, back, arm, or shoulder. Other symptoms include nausea, vomiting, sweating, palpitations, shortness of breath, and loss of consciousness.
5. Conditions of the pericardium
Problems at the level of the pericardium usually manifest with pain in the center of the chest that extends to the base of the lungs on the right or left side. It is described as a throbbing, shooting, pressing, or burning discomfort usually occurring gradually.
The most common causes are cardiac tamponade and constrictive pericarditis. A study in the journal CES Medicine indicates that distension of the jugular vessels is present in 93% of patients with pericarditis.
6. Pneumonia
Lung conditions commonly cause chest pain on the right or left side. A publication in the journal Pediatría Atención Primaria states that these present as a stitch in the chest that increases with inspiration, associated with coughing and respiratory distress. This particular type of discomfort is called pleuritic pain.
Pneumonia is the most common cause of this type of chest pain. According to a study in Nature Reviews, Disease primers are an infectious picture of the lower respiratory tract, whose most common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and respiratory viruses. Other symptoms of pneumonia are fever, shortness of breath, and coughing up. In most cases, a timely approach conditions rapid relief of symptoms and a lower risk of complications.
7. Pneumothorax
It is the accumulation of air between the pleural sheets that surround the lungs. The buildup of air can put pressure on the lung and cause it to collapse. Pneumothorax can affect one or both lungs, depending on the origin and the form of establishment.
In general, this entity manifests with chest pain and respiratory distress. According to a StatPearls publication, chest pain is stabbing at the right or left intercostal level, sharp, intense, and radiating to the affected side’s shoulder. In addition, the following signs may manifest:
- Increase in respiratory frequency.
- Chest asymmetry due to bulging on the affected side.
- Tachycardia and hypotension.
Although trauma can cause it, other possible causes include some medical procedures and even a spontaneous rupture of a fragile zone in the pleura. The treatment of pneumothorax depends on the severity of the clinical picture.
8. Pleural effusion
Unlike pneumothorax, in pleural effusion, there is fluid accumulation in the pleural space. The causes of this entity vary and range from benign flows accompanying infectious processes to highly relevant flows resulting from heart failure or cancer.
According to research in the Deutsches Arzteblatt international journal, pleuritic chest pain is the most common symptom arising from a pleural inflammatory response. Usually, affected people can express relief by lying on the side of the affected lung. A chest puncture is typically performed to remove the accumulated fluid.
9. Pleurisy
Pleuritis is nothing more than inflammation of the pleura that covers the lungs. Depending on the affected lung field, this presents with chest pain on the left or right side. It is usually a very intense discomfort that worsens with deep inspiration, sneezing, chest movements, and coughing, according to a StatPearls publication.
Infectious causes are the most common, one of the main complications being those caused by pneumonia and tuberculosis. Pain treatment is based on administering non-steroidal anti-inflammatory drugs and, in some instances, corticosteroids.
10. Pulmonary thromboembolism
It is an acute and fatal process that originates from the obstruction of the blood flow of the pulmonary artery. This is usually associated with the migration and entrapment of a thrombus or embolus. According to the Spanish Heart Foundation, risk factors include immobilization, prolonged bed rest, long trips, hypercoagulable states, obesity, cancer, and tobacco.
The clinical presentation of pulmonary thromboembolism is very varied. A study in the Sinergia Medical Journal describes that pleuritic chest pain manifests in 50% of affected people. In general, it is accompanied by respiratory distress, coughing, and expectoration of blood.
11. Tumors
Tumors located in the right lung are another cause of chest pain. However, when these conditions are found in the lung tissue, they are usually asymptomatic in the initial stages since they do not involve the parietal pleura.
According to a Lancet publication, lung cancer is one of the most diagnosed cancers worldwide, with 2 million new cases and 1.76 million deaths yearly.
In these patients, it is essential to inquire about weight loss, tobacco use, and chronic exposure to smoke and asbestos. In addition to pain, cough, and difficulty breathing are frequent.
12. Aortic pathology
Aortic dissection is a severe disease caused by a rupture of the wall of the aortic artery. An investigation by the CorSalud magazine concluded that chest pain is the predominant symptom of this condition and is present in up to 80% of patients.
In most cases, an intense chest tearing or stabbing discomfort is experienced. This can spread to the neck, back, and abdomen.
13. Panic attack
Panic attacks are triggered by episodes of stress or sustained anxiety. This condition usually leads to symptoms very similar to those of myocardial infarction. In this sense, it is common for the person to refer to pain in the center of the chest that extends to the right side and to the jaw and shoulder. Other symptoms include the following:
- Tingling and numbness of the hands.
- Respiratory distress.
- profuse sweating
- Agitation.
- Pallor.
Suspecting a panic attack, closing your eyes, and breathing deeply to calm down is advisable. If symptoms persist, medical attention should be sought as soon as possible.
14. Gastroesophageal reflux
This condition results from stomach acid rising into the esophagus, followed by irritation of the esophagus. Reflux causes a burning, heartburn, or burning sensation inside the chest. It is common for the discomfort to intensify after eating food. Other associated symptoms are the following:
- Dry cough.
- Difficulty swallowing.
- Pain in the throat.
- Frequent belching.
- The sensation of occupation in the throat and chest.
15. Intercostal neuritis
Irritation of the nerve fibers that accompany the ribs is called intercostal neuritis. It is a clinical picture with multiple causes: traumatic, infectious, and even nerve compression at some point along its path.
According to a StatPearls post, neuritis results in sharp, intense, burning, or stabbing pain associated with numbness and tingling. Also, it gets worse with deep breathing, sudden movements, and coughing. The pain covers the chest area when the affected nerve is on the right side.
It is essential to highlight that the pain does not usually exceed the intercostal space corresponding to the nerve’s sensitivity. In addition, on physical examination, it is characteristic that palpation is painful when pressure is applied to some points of this intercostal space.
16. Shingles
A vesicular rash on the skin and severe pain characterizes it. It is produced by the Varicella Zoster virus (VZV) reactivation. It is common in adults older than 50 and people with decreased immunity.
The most common location is on the chest walls. It begins with pain in the chest and the intercostal region, added to the appearance of blisters with a linear arrangement at 48 hours. Skin lesions usually evolve into scabs in 1 week, with traditional healing after 10 to 15 days.
Postherpetic neuralgia is the main complication of this condition. A publication in Current Pain and headache reports suggests that this manifests as burning or lancinating pain that persists for more than three months after the disappearance of the skin lesions.
17. Liver or gallbladder disease
Inflammation of the liver and gallbladder can cause pain on the right side of the chest due to the proximity of both organs to the thorax. The discomfort usually begins on the right side of the abdomen and spreads to the thoracic base. Some associated symptoms include the following:
- vomiting
- Dizziness.
- Yellow skin or jaundice.
- Loss of appetite.
Hepatitis and cholecystitis are some of the most common diseases. If you suspect a liver condition, it is advisable to consult a gastroenterologist.
You should not hesitate to seek medical attention.
As you can see, chest pain on the right side can be caused by various situations. Some are simple and require rest and treatment at home. However, this symptom could indicate some severe damage that compromises life.
It is advisable to seek medical attention as soon as possible if the pain is persistent and increases in intensity. Other warning symptoms include shortness of breath, high fever, confusion, and loss of consciousness.