Chest pain can be worrying, especially when it occurs on the left side. Left-sided chest pain can stem from various underlying causes, including issues related to the heart and its associated structures, the lung, and its adjacent structures, some GI conditions as well as the overlapping chest wall. To gain a comprehensive understanding of left-sided chest pain, it is essential to explore the components present on the left side and their respective locations.

Unraveling Left Chest Anatomy: Origins of Left-Sided Chest Pain:

When discomfort arises from the heart, conditions such as angina, myocardial infarction, or pericarditis can cause pain that radiates to the left arm, shoulder, or jaw. Similarly, lung-related problems like pneumonia, pleurisy, or pulmonary embolism can contribute to left-sided chest pain accompanied by respiratory symptoms. GI causes like hiatal hernia, gastritis, and pancreatitis can also cause pain in the lower left side sometimes. Additionally, pain arising from the chest wall, such as from muscle strains or injuries, can also manifest on the left side. Understanding the different components present on the left side and their respective locations is crucial in determining the various causes of left-sided chest pain.

Cardiac Causes of Left-sided Chest Pain:

Below is a brief overview of the heart and related structures that can cause chest pain.

• In Myocardial Infarction, also known as a heart attack, a portion of the myocardium (heart muscle) dies when the blood vessels (the coronary vessels) supplying the heart become blocked leading to a lack of blood supply to that area of the heart muscle.
• Angina: Characterized by chest pain that occurs when the heart muscle does not receive enough blood and oxygen due to narrowed or blocked coronary arteries. Pain is often described as tightness, pressure, heaviness, or squeezing in the chest. This pain lasts for seconds to minutes and spreads to the left side.
• Pericarditis: The pericardium, the sac-like membrane surrounding the heart, becomes inflamed. It causes sharp pain on the left side, worsened by lying or breathing profoundly and revealed by leaning forward. Pericarditis can be caused by a viral, bacterial, or fungal infection, as well as certain medical conditions, injuries, or medications.
• Myocarditis: The pain is vague and mild if present. It is inflammation of the heart muscles (myocardium). It can be caused by a viral, bacterial, or fungal infection, as well as exposure to certain toxins or medications. In severe cases, myocarditis can lead to heart failure or sudden death.

• Valvular diseases (Aortic stenosis and Mitral valve prolapse): These are conditions involving the heart valve. Aortic stenosis is a narrowing of the aortic valve due to calcification. This can restrict blood flow from the heart to the rest of the body, leading to symptoms such as chest pain (radiating to the neck, jaws, shoulder, or arms), shortness of breath, and fainting (syncope). In mitral valve prolapse, the valve between the heart’s left upper and lower chambers (mitral valve) doesn’t close properly, which can cause blood to leak back into the left atrium. This can lead to symptoms such as chest pain, heart palpitations, and shortness of breath.
• Acute coronary syndrome: The word acute means sudden. It is a condition in which there is a sudden obstruction in one or more vessels supplying the heart. Cholesterol plaque in the vessel wall rips (tears) and then a thrombotic clot forms in this area leading to this condition. Patients may have repetitive angina-like attacks or prolonged chest pain lasting more than 10 minutes.
• Aortic aneurysm: An aortic aneurysm occurs when a weakened section of the aorta’s wall bulges out due to blood pressure flowing through it. If left untreated, the weakened section may rupture and cause severe chest or abdomen pain that may radiate to the back. A ruptured aortic aneurysm is a life-threatening emergency that requires immediate medical attention.
• Aortic dissection: is a condition where the layers of the aorta, the largest artery in the body supplying blood from the heart to the body, separate from each other due to a tear in the aortic wall. This can cause sudden and severe chest, back, or abdominal pain that may feel like a tearing or ripping sensation. The pain can also radiate between the shoulder blades. It is also an alarming condition requiring prompt treatment.
• Coronary artery Disease: also known as Ischemic Heart Disease, refers to an imbalance between heart oxygen demand and supply resulting from insufficient blood flow from coronary vessels (the vessels supplying the heart) owing to partial or complete obstruction of one or more of these vessels.
• In coronary artery dissection, there may be a rip in the coronary vessel leading to a bulge and a block in the vessel supplying the heart.
• Hypertrophic cardiomyopathy (HOCM): the lower chambers of the heart may become thick leading to reduced blood flow in and out of the heart to the body. The heart has to work hard leading to chest discomfort.

Left-sided chest pain caused by GI diseases includes:

Some GI causes are explained here causing chest pain in the lower left area. Although these causes mainly affect the abdomen, they can sometimes cause discomfort in the lower area of your chest.

• A hiatal hernia is a condition where a part of the stomach protrudes through an opening in the diaphragm muscle. This opening is typically reserved for the esophagus.
• Gastritis is the inflammation of your stomach lining for different causes and can lead to pain in the lower left chest along with abdominal hurting.
• Pancreatitis: inflammation of your pancreas can also result in severe pain in the upper abdomen radiating to the adjacent lower chest. The pain experienced by patients suffering from pancreatitis is also very severe.

Lung issues and Chest wall conditions:

The left lung and its associated structures can be involved in various conditions that result in left-sided chest pain. Some of these conditions include pulmonary hypertension, pulmonary embolism, asthma, COPD (Chronic Obstructive Pulmonary Disease), pneumonia, pleurisy, pleuritis, and pneumothorax. Each of these conditions has its unique characteristics and can cause discomfort and pain on the same side of the chest in addition they have associated respiratory symptoms as well. In my upcoming posts, I will provide an overview of these conditions. Stay tuned to learn the causes of chest pain on either side of the chest.

In addition to the conditions mentioned above involving the left lung, several other factors can contribute to left-sided chest pain. These include broken ribs, which can occur due to accidents or trauma; muscular spasms, which can result from muscle strain, sudden exposure to cold temperature or overexertion (patient complaints of sharp or dull pain which is more on breathing or chest wall movement); and shingles, a viral infection that can cause sharp, burning pain along the affected nerve pathways. Costochondritis is usually considered as a symptom of middle chest pain but some patients complain more specifically as pain on the left or right more towards the middle. Each of these conditions’ history usually speaks for symptoms and causes chest discomfort on the involved side. In my upcoming posts, I will provide detailed insights into these conditions, exploring their causes, symptoms, and potential treatment options. Stay tuned to learn about these causes of left-sided chest pain and how to alleviate them effectively.

Conclusion:

Left-sided chest pain can have various origins, including the heart, left lung, GIcause, and chest wall. By recognizing the locations and associated structures on the left side, we can gain a better understanding of the potential causes of chest pain. Although most of the time the symptoms of a specific cause are typical and helpful in making a diagnosis, the presentation may be atypical or misleading. In certain types of heart attacks, for instance, patients have a complaint of burping or pain in the center of the chest just below the breast bone. Considering it is gastric in origin and ignoring may be life-threatening. So it is mandatory always to seek medical attention for chest pain for accurate diagnosis and prompt treatment.