Chest pain upon waking can occur due to serious heart- or respiratory-related causes but can also occur due to digestion issues and stress. Some causes may need emergency medical care.
Waking up with chest pain can be unsettling. The pain might be caused by a minor problem, such as stress or indigestion. The pain might also be caused by a serious problem, such as a heart attack or a pulmonary embolism.
Chest pain should always be taken seriously.
If the pain lasts for more than a few minutes, your best course of action — according to the Mayo Clinic — is to get emergency medical attention. Don’t rely on self-diagnosis. As the old saying goes, “It’s better to be safe than sorry.”
- Heart attack. When an artery supplying oxygen to your heart muscle is blocked, you’re having a heart attack. This blockage is often due to a blood clot.
- Angina. Angina is chest pain caused by reduced blood flow to your heart. It’s often caused by plaque buildup in the arteries that carry blood to your heart.
- Pericarditis. Inflammation in the sac surrounding your heart is called pericarditis. It commonly causes pain that worsens when you take a breath or lie down.
- Myocarditis. If your heart muscle (myocardium) becomes inflamed, it can cause rapid or abnormal heart rhythms called arrhythmias.
- Aortic dissection or rupture. This life-threatening condition occurs when the inner layers of the aorta — the main artery leading from your heart — separate and the aorta tears.
- Heartburn. A symptom of acid reflux or gastroesophageal reflux disease (GERD), heartburn is caused by stomach acid moving back up into the tube that connects your throat to your stomach (esophagus). This irritates the lining and causes a burning sensation in your chest.
- Dysphagia. A term for swallowing disorders, dysphagia commonly affects the top of the throat or farther down the esophagus, making swallowing difficult and painful.
- Pancreatitis. When your pancreas — a large gland located behind your stomach — becomes inflamed it can result in upper abdominal pain that can radiate to the chest.
- Gallstones. Gallstones and inflammation of your gallbladder can cause abdominal pain that extends to your chest.
- Pulmonary embolism. When a blood clot gets lodged in an artery in one of your lungs and blocks blood flow to lung tissue, it’s called a pulmonary embolism. It commonly causes chest tightness and pain that feels like a heart attack.
- Pleurisy. When the pleura — the membrane that surrounds your lungs and lines the inner wall of your chest cavity — becomes inflamed, it can cause chest pain that increases when you cough or inhale.
- Pulmonary hypertension. High blood pressure is called hypertension. High blood pressure in the pulmonary arteries — blood vessels that carry blood to the lungs — is called pulmonary hypertension. It can result in a tight feeling in your chest along with a racing heartbeat.
- Lung cancer. Lung cancer is abnormal cell growth in your lungs that interferes with the healthy functioning of your lungs. Lung cancer commonly causes chest pain that increases with deep breathing or coughing.
- Collapsed lung. Also called pneumothorax, a collapsed lung occurs when air leaks into the space between your lung and your chest wall keeping your lung from expanding when you breathe in.
- Costochondritis. When the cartilage of your rib cage becomes inflamed, it’s called costochondritis. This condition can cause pain that is similar to a heart attack, particularly when the inflammation is in cartilage that joins your ribs to your breastbone.
- Panic attack. You might be experiencing a panic attack if you have chest pain combined with a racing heartbeat, rapid breathing, and profuse sweating. Panic attacks also often include dizziness, nausea, and feelings of intense fear.
- Injury. An injury such as muscle strain or a broken rib can cause chest pain. When you’re sleeping, movement such as twisting or turning your upper body can intensify the discomfort, resulting in waking up with chest pain.
If you wake up with chest pain, your first consideration should be whether or not it’s from a known source. For example, if you have a broken rib or have been diagnosed with pancreatitis, chances are the discomfort is related to an existing condition that’s being treated.
If the pain is unexpected and without an easily identifiable source, wait a few minutes. If the pain doesn’t go away, seek emergency medical attention.
Although, the pain might be caused by a relatively minor problem such as indigestion or anxiety, it might also be caused by a serious problem.
A serious problem — such as an aortic dissection, pulmonary embolism, or heart attack — could be life-threatening and should be treated immediately.