Experiencing chest pain on the right side is a frequently encountered complaint but it does not necessarily point towards a chest problem.
Chest pain that occurs on the right side of the chest may be due to a number of causes. Some of these causes are not even related to the chest wall cavity and its contents.
The pain is either due to a direct insult of a structure or indirectly by referred pain from a distant part of the body.
Some reasons are mild and resolve with OTC medications. However, there are a number of alarming causes that require urgent medical attention.
The analysis of the pain by a medical professional as regards character, severity, duration, frequency, associated symptoms, and increasing or relieving factors is essential to reach a probable cause.
This article will outline numerous causes of right-sided chest pain and point out the symptoms and signs necessitating immediate medical care.
Causes of Right-sided Chest Pain
Chest wall causes:
1. Trauma and/or rib fracture:
Any sharp or blunt trauma to the chest may damage the structures and lead to a rib fracture. Penetrating chest wall injuries are the most serious.
An accident at work, an injury while playing sports, or a road traffic accident may result in a closed or penetrating injury that may affect the internal organs like the lung and heart.
Do not hesitate to seek medical advice in case of a trauma that gives chest pain with associated alarming symptoms.
2. Muscle strain:
Your chest wall is rich in many different muscle fibers running in several directions. Abnormal movements, stress, or strenuous activity may sprain those muscles.
This condition can be simply treated with appropriate rest, local applications, and/or painkillers.
It sounds scary but it indicates an inflammation of the cartilage that connects your rib to the breastbone located in the front of your chest wall.
Direct injury, cough, or an infection may lead to intolerable pain from this inflammation. It is usually a localized pain but may affect more than one costochondral junction.
Tietze syndrome is a rare entity that causes chest pain and swelling due to costochondritis.
Costochondritis is usually a self-limiting condition that requires rest, local cold/hot compresses, and painkillers.
1. Pleural conditions:
Pleurisy, an inflammation of the surrounding sac encircling the lungs, is a common cause of stitching pain that increases with taking a deep breath. The pain is sharp and may be severe as a result of dry friction of both layers of the sac rubbing against each other.
The actual sliding of both pleural layers during normal respiration is smooth and painless in the absence of inflammation.
2. Pleural effusion:
This term used to describe the abnormal accumulation of fluid in the pleural sac, is another cause of chest pain. It may be associated with progressive shortness of breath and dry cough.
The shortness of breath develops due to compression of the underlying lung by accumulating fluid. The dry cough is due to direct irritation of the pleura.
It is the abnormal presence of air in the pleural cavity and is a serious cause of right-sided chest pain. It is usually a sudden sharp pain after a strenuous act like coughing or sneezing.
The air may accumulate in the pleural sac and lead to complete compression and collapse of the underlying lung. Therefore, the chest pain may be associated with rapidly progressive shortness of breath, dizziness, racing heartbeats, and/or sudden collapse.
The development of an inflammation of the lung tissue adjacent to the overlying pleural surface may lead to pleurisy. Therefore the pain associated with pneumonia is due to pleurisy.
5. Pulmonary embolism:
This serious condition occurs when the blood vessel that carries blood from the right side of the heart to the lungs becomes blocked with a clot. When this happens on the right side of the vascular tree, it results in right-sided chest pain.
Furthermore, it is a rather sudden or rapid condition that may also be associated with shortness of breath, racing heartbeats, and/or coughing blood.
6. Thoracic tumors:
Lung cancer may present with chest pain if it originates from the right side. The tumor invades surrounding structures including the pleural cavity resulting in persistent pain. Other associated symptoms include progressive shortness of breath, chronic cough, and/or coughing of blood.
Any right-sided chest wall benign or malignant tumor will grow to pressure surrounding structures especially nerves resulting in discomfort and pain.
1. Heart disease:
Commonly, heart conditions such as heart attacks give rise to left-sided chest pain.
Rarely, the chest pain may occur on the right side of the chest. For example, less than 1% of people are born with dextrocardia, where the heart is aberrantly located on the right side.
Pericarditis, an inflammation of the sheath around the heart, gives rise to chest pain that may occur on the right side.
2. Dissecting aortic aneurysm:
This is another emergency that causes sudden, severe, tearing chest pain. It is more common in those suffering from elevated blood pressure.
The idea behind it is that a tear occurs in the lining of the aorta causing blood to flow between the layers of this major blood vessel. Consequently, the wall is dissected causing a compromise in blood flow to vital organs, which is life-threatening.
1. Stomach reflux/Heartburn:
Your stomach lining is created to withstand the strongly acidic environment present to digest the food we eat. However, the food pipe has a different surface lining that becomes injured upon contact with reflux of stomach acid.
This leads to so-called heartburn sensation, which may be felt on the right side of the chest.
Note that some types of food may aggravate heartburn and bring the chest pain.
2. Liver and Gallbladder:
These structures are located in the abdomen and play an essential role in digestion and absorption of food. They are located in the right upper quadrant of the abdomen separated from the right lung and pleura by a muscle called the diaphragm.
Any injury or infection that leads to their inflammation will cause referred pain felt on the right side of the chest and/or right shoulder.
Another abdominal organ that has several functions and it is located in the upper central part of the abdominal cavity.
Inflammation of this organ called pancreatitis can lead to central abdominal pain, which may be referred to the right side of the chest and back.
1. Anxiety and stress:
Overwhelming anxiety and stress may lead to a number of symptoms including those simulating a heart attack.
The anxiety attack may give rise to chest pain, shortness of breath, a racing heart, dizziness, and a sense of impending death.
Whenever you are uncertain, medical attention is essential to rule out serious causes before initiating appropriate treatment for anxiety disorders.
This is an infection caused by the same virus that gave you chickenpox. Reactivation of the virus leads to inflammation of a designated nerve supplying a region of your skin called a dermatome.
The affected dermatome gives rise to hypersensitivity and pain. Furthermore, a painful itchy rash develops. If the affected nerve supplies the chest on the right side, it will result in chest pain.
When Should I Seek Medical Advice?
As a general rule, any chest pain should be reported to a physician. A number of causes require urgent medical attention.
Seek immediate medical advice if:
- Sudden onset of severe chest pain.
- Tearing or crushing character of chest pain.
- Chest pain associated with difficulty in breathing.
- Chest pain associated with dizziness, weakness, and/or alteration in the level of consciousness.
- Chest pain associated with fever, nausea, and vomiting.