Chest pain is one of the most common reasons people seek medical treatment. Every year, about 5.5 million people get treatment for chest pain. However, for about 80 to 90 percent of these people, their pain isn’t related to their heart.
Headaches are also common. In rare cases, people may experience a headache at the same time they experience chest pain. When these symptoms occur together, they may indicate the presence of certain conditions.
Note that even if the chest pain and headache aren’t related to a serious condition, such as a heart attack or stroke, many causes of chest pain require urgent medical attention.
Chest pain and headache rarely occur together. Most conditions they’re both associated with are also uncommon. A very rare condition called cardiac cephalgia limits blood flow to the heart, which leads to chest pain and a headache. Other possible causes linking the two include:
There is a relationship between the mind and body. When a person experiences depression or extreme, long-lasting feelings of sadness or hopelessness, symptoms of headache and chest pain may occur. People with depression often report physical symptoms such as backaches, headaches, and chest pain, which may or may not be related to somatization.
High blood pressure (hypertension) doesn’t cause any symptoms unless it’s uncontrolled or end stage. However, when blood pressure gets very high, you may have chest pain and a headache.
The idea that high blood pressure causes headaches is controversial. According to the American Heart Association, evidence suggests headaches are usually only a side effect of very high blood pressure. A blood pressure that may cause symptoms could be a systolic pressure (top number) greater than 180 or a diastolic pressure (bottom number) greater than 110. The chest pain in times of very high blood pressure may be related to extra strain on the heart.
Another condition that involves chest pain and headache is an infectious disease called Legionnaires’ disease. The bacteria Legionella pneumophila causes the disease. It’s mostly spread when people inhale water droplets contaminated with the L. pneumophila bacteria. Sources of these bacteria include:
- hot tubs
- swimming pools
- physical therapy equipment
- contaminated water systems
In addition to chest pain and headache, the condition can cause symptoms such as:
Lupus is an autoimmune disease in which the immune system attacks healthy tissues. The heart is a commonly affected organ. Lupus can lead to inflammation in different layers of your heart, which can cause chest pain. If the lupus inflammation also extends to the blood vessels, it can cause headaches. Other symptoms may include:
According to a 2014 study published in the Journal of Emergency Medicine, chest pain can be a symptom of a migraine headache. However, this is rare. Migraine headaches are severe headaches that aren’t related to tension or sinuses. Researchers don’t know what causes chest pain to occur as a migraine side effect. But treatments for migraines will typically help resolve this chest pain.
A subarachnoid hemorrhage (SAH) is a serious condition that results when there is bleeding in the subarachnoid space. This is the space between the brain and the thin tissues that cover it. Having a head injury or bleeding disorder, or taking blood thinners, can lead to a subarachnoid hemorrhage. A thunderclap headache is the most common symptom. This type of headache is severe and starts suddenly. Other symptoms can include:
- peptic ulcer
- Chinese restaurant syndrome
- alcohol withdrawal delirium (AWD)
- heart attack
- malignant hypertension (hypertensive emergency)
- systemic lupus erythematosus (SLE)
- carbon monoxide poisoning
- infectious mononucleosis
Sometimes a person has chest pain as a symptom of one condition and a headache as a symptom of a separate condition. This could be the case if you have a respiratory infection and are also dehydrated. Even if the two symptoms aren’t directly related, they can be cause for concern, so it’s best to seek medical attention.
Chest pain and headache are two concerning symptoms. Your doctor will start the diagnostic process by asking you about your symptoms. Questions might include:
- When did your symptoms start?
- How bad is your chest pain on a scale of 1 to 10? How bad is your headache on a scale of 1 to 10?
- How would you describe your pain: sharp, aching, burning, cramping, or something different?
- Is there anything that makes your pain worse or better?
If you have chest pain, your doctor will likely order an electrocardiogram (EKG). An EKG measures the electrical conduction of your heart. Your doctor can look at your EKG and try to determine if your heart is under stress.
Your doctor will also likely order blood tests that include:
- Complete blood count. Elevated white blood cells could mean the presence of an infection. Low red blood cells and/or platelet count could mean you are bleeding.
- Cardiac enzymes. Elevated cardiac enzymes could mean your heart is under stress, such as during a heart attack.
- Blood cultures. These tests can determine if bacteria from an infection are present in your blood.
If needed, your doctor could also order imaging studies, such as a CT scan or a chest X-ray. Because there are so many possible causes of these two symptoms, your doctor may have to order several tests before making a diagnosis.
Several symptoms can go along with a headache and chest pain. These include:
- muscle aches (myalgia)
- neck stiffness
- rash, such as under the armpits or across the chest
- trouble thinking clearly
If you experience these symptoms along with chest pain and headache, seek immediate medical attention.
Treatments for these two symptoms vary based on the underlying diagnosis.
If you’ve been to the doctor, and they’ve ruled out a serious cause or an infection, then you can try at-home treatments. Here are some possible approaches:
- Get plenty of rest. If you have an infection or a muscle injury, rest can help you recover.
- Take an over-the-counter pain reliever. Nonsteroidal anti-inflammatory drugs such as acetaminophen (Tylenol) and ibuprofen (Advil) can help reduce symptoms of headache and chest pain. However, aspirin can make the blood thinner, so it’s important your doctor rules out any bleeding disorder before you take it.
- Apply a warm compress to your head, neck, and shoulders. Taking a shower can also have soothing effects on a headache.
- Minimize stress as much as possible. Stress can contribute to headaches and body pain. There are many activities that can help you reduce stress in your life, like meditation, exercise, or reading.
Remember that even if your doctor ruled out a serious condition, it’s possible that headache and chest pain could become more severe. If your symptoms get worse, seek medical attention again.