There are a couple of reasons a hiatal hernia can lead to chest pain.

A hernia is when part of your insides bulges through your muscle or other tissues. A hiatal hernia occurs when the top of your stomach or another internal organ pushes through an opening in your diaphragm called the esophageal hiatus.

The esophageal hiatus is a hole that allows the base of your esophagus to pass through your diaphragm.

Hiatal hernias can cause symptoms like:

GERD is the most common hiatal hernia symptom. This is the recurring backup of stomach acid into your esophagus.

Burning chest pain is a potential symptom of GERD associated with hiatal hernias. Chest pain can also develop due to the compression of organs like your heart or lungs.

Read on to learn more about the connection between chest pain and hiatal hernias.

Hiatal hernias are very common in the general population and become more common with age. They’re estimated to occur in about 55–60% of people over age 50 and cause symptoms in about 9%.

Hiatal hernias are divided into types 1–4 depending on their features.

  • Type 1 (Sliding hernias): These occur when the top of your stomach protrudes through your diaphragm. It normally rests just below your diaphragm.
  • Type 2: These occur when part of the stomach protrudes above your diaphragm next to your esophagus. Type 2–4 hernias are also called paraesophageal hernias.
  • Type 3: A type 3 hernia shares features of type 1 and type 2.
  • Type 4: These are the most serious. They involve the protrusion of another organ, such as part of your bowels, through your diaphragm.

Sliding hernias make up about 90% of hiatal hernias. Symptoms of sliding hernias, including chest pain, are mainly due to GERD.

Paraesophageal hernias may also cause chest pain if your heart or lungs are compressed.

GERD and heartburn

When your stomach pushes through your diaphragm, it can compromise the strength of your lower esophageal sphincter (LES). This sphincter is a tight band of muscle that keeps stomach acid from backing up. Weakness of your LES can cause chronic heartburn or GERD.

GERD is the most common symptom associated with all types of hiatal hernias. The classic symptom is chronic burning in your chest that radiates toward your mouth. For some people, chest pain caused by GERD may replicate chest pain caused by a heart attack.

Less common GERD symptoms include:

  • a feeling of fullness in your throat
  • hoarseness
  • chronic need to clear your throat
  • nausea and vomiting
  • bronchospasms, which may exacerbate asthma and cause:
    • shortness of breath
    • cough
    • wheezing

Pressure on the heart and respiratory system

As more of your stomach or other organs move through your diaphragm, they may put pressure on your heart or lungs. This pressure can cause chest pain and other symptoms, such as:

Extreme hernias can cause compression of your heart and pulmonary veins, leading to swelling in your lungs and heart failure.


Strangulation occurs when your stomach or another organ is compressed by the hernia and loses its blood supply. Strangulation is a medical emergency that might cause sudden and intense chest pain. Other symptoms include:

Many people who develop hiatal hernias don’t have any symptoms. New chest pain or chest that becomes progressively worse may be a sign that your hernia is getting worse.

It’s a good idea to see a doctor if you develop unidentified chest pain or other concerning symptoms, such as trouble breathing.

If you’ve already been diagnosed with a hiatal hernia, see your doctor if you notice a change in your symptoms.

Medical emergency

It’s critical to call emergency medical services or go to the nearest emergency room if you develop intense pain that onsets suddenly or you develop symptoms that can also be a sign of a heart attack, such as:

  • nausea
  • cold sweat
  • fatigue
  • trouble breathing
  • pain that spreads to your shoulder, arm, back, neck, or jaw

If your chest pain is caused by GERD, you might be able to find relief with a combination of dietary changes and medications called proton pump inhibitors.

Surgery is the main treatment for severe hiatal hernias or hernia that causes symptoms that don’t respond to more conservative treatments.

Learn more about how hiatal hernias are treated.

Here are some frequently asked questions that people have about hiatal hernias and chest pain.

What does chest pain from a hiatal hernia feel like?

Chest pain from hiatal hernia-related GERD may feel like a painful burning in the middle of your chest. Chest pain can also sometimes mimic pain associated with a heart attack, so it’s important to see a doctor.

Where would I feel pain from a hiatal hernia?

You may feel pain in the center of your chest near the level of your diaphragm, around the base of your chest. GERD often causes burning that starts in the chest and radiates toward your throat and mouth.

What are the symptoms of a hiatal hernia getting worse?

If your hernia is getting worse, you may experience progressive pain or pressure in your chest or fullness after eating. Intense and sudden pain is a sign that your hernia requires immediate medical attention.

Hiatal hernias occur when part of your stomach or other internal organs protrude through your diaphragm. The most common symptom is GERD, which can cause burning chest pain.

Severe hiatal hernias can put pressure on your heart or other internal organs that might also cause chest pain. If part of your stomach loses its blood supply you may develop sudden intense chest pain.