Is this cause for concern?

You have a painful burning feeling in your chest. Is it heartburn? Or, is it something much more serious, like a heart attack?

Pain, burning, and other uncomfortable sensations in the chest lead to 8 million emergency room visits each year. But only a small percentage of these cases are truly life-threatening.

Oftentimes, the cause is something completely unrelated to the heart — like heartburn, asthma, or an ulcer.

Keep reading to learn more about the symptoms to watch for and when to seek medical attention.

When to seek emergency medical attention

You usually won’t need to call an ambulance or visit an emergency room for burning in your chest.

But if you’re experiencing any of the following, the burning in your chest may be a sign of a heart attack or dangerously abnormal heart rhythm:

  • squeezing, fullness, pain, burning, or pressure in the middle or left side of your chest
  • pain that spreads to your jaw, neck, shoulders, arms, or back
  • shortness of breath
  • nausea
  • vomiting
  • dizziness
  • extreme fatigue
  • sweating
  • abnormally slow or fast heartbeat

If you have these symptoms, call your local emergency services or have someone drive you to the emergency room immediately. Quick response and treatment could save your life.

1. Heartburn

Symptoms of heartburn and a heart attack are easy to confuse. Both can cause a burning sensation in your chest. And because heartburn is reported in up to 40 percent of U.S. adults, it’s a very common reason for this symptom.

You experience heartburn when stomach acid backs up into your esophagus. This is the tube that carries food from your mouth to your stomach. A band of muscle at the bottom of your esophagus normally closes when you’re not eating to keep food and acid inside your stomach. If it relaxes prematurely, acids can back up into your esophagus.

In heartburn, the burning feeling often begins after you’ve eaten, or at night. It may get worse when you lie down or bend over. You might also have a sour taste in your mouth.

Other common causes

Here are a few other common conditions that can cause burning sensations in your chest.

2. GERD

Gastroesophageal reflux disease (GERD), or acid reflux, is when acid regularly backs up from your stomach into your esophagus.

Heartburn is a symptom of GERD. When you have GERD, you may get heartburn and other acid reflux symptoms once or more a week. At least 20 percent of U.S. people have GERD.

Other symptoms include:

  • trouble swallowing
  • feeling like there’s a lump in your throat
  • bringing up food or sour liquid into your throat
  • cough
  • hoarse voice
  • asthma
  • trouble sleeping

3. Esophagitis

Frequent episodes of stomach acid backup from GERD can cause inflammation in the esophagus, called esophagitis. Food allergies, infections, and certain medications can also cause this condition. The allergy-related form of esophagitis affects about 10 out of every 100,000 people each year.

Over time, esophagitis can scar and narrow the lining of the esophagus. This can affect its ability to carry food to your stomach.

In addition to chest burning and pain, esophagitis can cause:

  • painful swallowing
  • difficulty swallowing
  • a sensation of food being stuck in the esophagus

4. Stomach ulcer

An ulcer is an open sore in the stomach. It’s caused by acid wearing away at the stomach lining. This usually results from H. pylori bacteria and excessive use of over-the-counter (OTC) pain relievers.

With an ulcer, the burning will be in your stomach, or the center of your chest. The pain may get worse at night or after you eat.

Other symptoms include:

  • bloating or a full feeling
  • belching
  • nausea

5. Hiatal hernia

A hiatal hernia occurs when part of your stomach pushes through a hole in your diaphragm into the chest cavity. You’re more likely to get this condition if you smoke, are overweight, or are over 50 years old.

The symptoms of a hiatal hernia are similar to those of GERD, including burning in the chest and:

  • bloating
  • belching
  • heartburn
  • sour taste in the back of the throat
  • pain in the stomach or esophagus

6. Pneumonia

Pneumonia is an infection that makes the lungs fill with air or pus. Bacteria, viruses, and fungi can all cause pneumonia.

Chest pain from pneumonia can start when you take a breath or cough. Other symptoms include:

  • cough
  • fever
  • chills
  • shortness of breath
  • fatigue
  • nausea
  • vomiting

The symptoms can vary depending on what type of germ caused the infection. Pneumonia can be very serious, so see your doctor right away if you’re experiencing any symptoms.

7. Pleurisy

Pleurisy occurs when the tissue lining your chest wall and surrounding your lungs becomes irritated and inflamed. Infections, certain medications, and autoimmune disorders can all cause pleurisy.

The pain from pleurisy is sharp. It will get worse when you breathe in.

Other symptoms include:

  • cough
  • shortness of breath
  • fever
  • pain in the shoulders or back

8. Shingles

Shingles is an infection caused by the same virus (varicella-zoster) that causes chickenpox in childhood. After the chickenpox rash clears up, the virus hides out in your body. As you age and your immune system weakens, that virus can reemerge and cause shingles.

About 1 in 3 U.S. adults get shingles during their lifetime. The rate among people age 60 and older is 10 out of every 1,000 people.

The most notable symptom of shingles is a painful, burning, blistering rash on one side of your body. Other symptoms include:

  • itching
  • fever
  • headache
  • fatigue

9. Angina

Angina is chest pain that’s triggered by a lack of blood to your heart. It’s not a disease, but rather a symptom of coronary heart disease or another condition that restricts blood flow to the heart.

Just over 2 million medical visits each year are due to angina. Though angina isn’t a heart attack, it can feel like one. Its symptoms include pain and pressure in your chest that can radiate into your arms, shoulder, neck, jaw, or back. Like a heart attack, the pain can also mimic heartburn.

Other signs of angina include:

  • fatigue
  • shortness of breath
  • nausea
  • sweating
  • dizziness

Because these symptoms are so similar to those of a heart attack, you should get them checked out as soon as possible.

10. Anxiety

Anxiety disorders are an incredibly common type of mental illness. They affect 40 million U.S. adults every year.

The symptoms of an anxiety attack can so closely mirror those of a heart attack that it’s hard to tell the two apart. Chest pain, a pounding heart, dizziness, and sweating occur with both conditions.

Because the symptoms of anxiety and a heart attack can overlap so much, you should get medical help if you’re not sure which one you have.

11. Asthma

About 26 million Americans have asthma — a disease in which the airways in the lungs narrow. This narrowing prevents enough oxygen from getting into the lungs and to the rest of the body.

During an asthma attack, your chest can feel tight and it may be hard to catch your breath. Other symptoms include:

  • coughing
  • wheezing
  • trouble sleeping, if you have asthma attacks at night

Less common causes

A few other conditions can cause a burning feeling in your chest, although they’re much less common reasons for this symptom.

12. Pulmonary embolism

Pulmonary embolism (PE) is a blockage in a blood vessel of the lung. It’s usually caused by a blood clot that travels to your lung from your leg (deep vein thrombosis) or other parts of your body.

PE can cause pain in your chest that gets worse when you breathe in, cough, eat, or bend over. Other symptoms include:

  • shortness of breath that gets worse with exertion
  • cough, sometimes bringing up blood
  • fast or irregular heartbeat
  • dizziness
  • swelling, tenderness, and warmth in the leg

PE is considered a life-threatening emergency, so you should seek immediate medical attention if you’re experiencing symptoms.

13. Heart attack

Only a small percentage of people with chest pain are actually having a heart attack. But because a heart attack is a medical emergency, it’s important to be alert for the warning signs.

A heart attack happens when a blood vessel that supplies the heart is blocked. The lack of oxygen-rich blood causes the affected parts of the heart muscle to die.

Chest pain from a heart attack feels like a pressure, squeezing, burning, or pain in the middle or left side of your chest. The pain may go away and come back. It can also radiate to your arms, back, neck, jaw, or stomach.

Other symptoms of a heart attack include:

  • shortness of breath
  • cold sweat
  • nausea
  • dizziness

If you have these symptoms, call your local emergency services or have someone take you to the emergency room right away.

14. Gastroparesis

Gastroparesis is a problem with the muscles that push food through your stomach and into your intestines. When these muscles don’t work like they should, food can’t properly empty from your stomach.

If you have gastroparesis, you’ll feel full and bloated soon after you eat. You may also have pain in your upper abdomen or heartburn.

Other symptoms of gastroparesis include:

  • nausea
  • vomiting, sometimes throwing up undigested food
  • belching
  • lack of appetite
  • weight loss

Causes affecting women

The following conditions that cause burning in the chest can affect anyone, but they’re more common in women.

15. Costochondritis

Costochondritis is inflammation of the cartilage that connects your rib to your breastbone (sternum). It may be caused by an injury or arthritis, but sometimes the cause isn’t clear.

The pain can feel similar to that of a heart attack — pressure or sharp pain on the left side of your chest. The pain may get worse when you take a deep breath or cough.

Because of the similarities between costochondritis and a heart attack, you should see your doctor right away if you’re experiencing these symptoms.

16. Gallstones

Gallstones are hard deposits that form in your gallbladder. Your gallbladder’s job is to release bile into your small intestine to help digest food.

Up to 15 percent of adults — or 25 million Americans — will get gallstones at some point in their lives. Some gallstones don’t cause any symptoms. But if they get stuck in a duct and cause a blockage, you’ll feel a sudden and intense pain, often in the center or right side of your abdomen. The pain may spread to your shoulder or upper back.

The pain from a gallbladder attack can last from a few minutes to a few hours. You might have nausea and vomiting along with the pain.

Causes affecting men

The following conditions can affect anyone, but it’s more common in men.

17. Pericarditis

Pericarditis is inflammation of the pericardium. This is the multilayered tissue that surrounds the heart and holds it in place in your chest. Infections and autoimmune diseases can cause pericarditis.

With pericarditis, you’ll feel the pain in the middle or left side of your chest. It’s sharp, stabbing, and it comes on quickly. The pain eases up when you sit up and lean forward, and it may get worse when you lie down or breathe in deeply.

Other symptoms include:

  • trouble breathing or shortness of breath
  • coughing
  • weakness
  • fast or fluttering heartbeat
  • skipped heartbeats
  • fatigue
  • swelling in the stomach and legs

Because the symptoms of pericarditis are similar to those of a heart attack, you should seek immediate medical attention if you’re unsure of your symptoms.

When to see your doctor

Any chest pain is worth noting — and reporting to your doctor if it doesn’t go away.

You should seek immediate medical attention if you experience shortness of breath, fast or irregular heartbeat, or dizziness alongside your chest pain. Even if the cause turns out to be nothing serious, you don’t want to take any chances.