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What’s Causing My Chest Pain and Headache?

Overview

Chest pain is one of the most common reasons people seek medical treatment. Every year, about 5.5 million people seek treatment for chest pain. However, for about 80 to 90 percent of these people, their pain isn’t related to their heart at all.

Headaches are also very common. In rare cases, people may experience a headache at the same time they experience chest pain. When these symptoms occur together, there are some conditions to consider.

Note that even if the chest pain and headache are not related to a serious condition, such as a heart attack or stroke, many causes of chest pain prompt urgent medical attention.

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Causes

Possible causes of chest pain and headache

Since chest pain and headache rarely occur together, most conditions they’re associated with are uncommon too. A very rare condition called cardiac cephalgia causes limited blood supply to the heart, which in addition to chest pain also causes a headache. Other possible causes linking the two include:

Depression

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.

Hypertension

Unless it is very uncontrolled or end-stage, high blood pressure (hypertension) doesn’t cause any symptoms at all. However, when blood pressure gets very high, you may experience symptoms that include chest pain and headache. The idea that high blood pressure causes headaches is a controversial one. 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 the extra strain on the heart.

Legionnaires’ disease

Another condition that involves chest pain and headache as symptoms 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 Legionella bacteria. Sources of these bacteria include:

  • hot tubs
  • fountains
  • swimming pools
  • physical therapy equipment
  • contaminated water systems

In addition to chest pain and headache, the condition can cause symptoms such as:

  • high fever
  • cough
  • shortness of breath
  • nausea
  • vomiting
  • confusion

Lupus

Lupus is an autoimmune disease, meaning the body attacks itself. In the case of Lupus, the immune system attacks healthy tissues. The heart is unfortunately a commonly affected area. 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, headaches can be a side effect. Other symptoms may include:

  • blurred vision
  • appetite loss
  • fever
  • neurologic symptoms
  • skin rash
  • abnormal urine

Migraines

According to a 2014 study published in the Journal of Emergency Medicine, chest pain can be a side effect of a migraine headache, although it’s a rare occurrence. Migraine headaches are severe, intense headaches that aren’t related to tension or sinuses. Although researchers don’t know what causes chest pain to occur as a migraine side effect, treatments for migraines will typically help resolve your chest pain.

Subarachnoid hemorrhage

A subarachnoid hemorrhage 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 very severe and starts suddenly. Other symptoms can include:

  • chest pain
  • difficulty adjusting to bright lights
  • neck stiffness
  • double vision
  • mood changes

Other causes may include:

Unrelated causes

Sometimes a person has chest pain as an effect of one condition and a headache as an effect of a separate condition. This is a more likely scenario. This could be the case if you have a respiratory infection and are also dehydrated. Even if the two symptoms aren’t directly related to each other, they can be concerning, so it’s best to get them checked out.

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Diagnosis

How do doctors diagnose these symptoms?

Chest pain and headache are two concerning symptoms. Your doctor would start their 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). This measures the electrical conduction of your heart. Your doctor can look at your EKG and try to determine if your heart is under some kind of stress.

Your doctor will also likely order blood tests. Examples could 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 computed tomography scan or a chest X-ray. Because there are so many different causes of these two symptoms, your doctor may have to order several tests before making a diagnosis.

Additional symptoms a person may experience

Several symptoms can go along with a headache and chest pain. These include:

  • bleeding
  • dizziness
  • fatigue
  • fever
  • muscle aches
  • neck stiffness
  • nausea
  • vomiting
  • rash, such as under the armpits or across the chest
  • trouble thinking clearly

If you experience these symptoms as well as chest pain and headache, seek immediate medical attention.

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Treatment

How are these conditions treated?

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 to start feeling better through 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 and recuperate.
  • Take an over-the-counter pain reliever. Nonsteroidal anti-inflammatory drugs such as acetaminophen and ibuprofen can help reduce symptoms of headache and chest pain. Remember that 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 in your life as much as possible. Stress can contribute to headaches and body pain. From meditation to exercise to reading, there are many activities that can help you reduce stress in your life.
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Outlook

Outlook

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 instead of better, seek medical attention again. 

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