What Are the Causes of Right-Side Chest Pain?

Right-sided chest pain has many possible causes including lung, digestive, and heart-related issues. It can be the sign of minor injury, like a muscle strain, or a more serious condition. While left-sided chest pain is usually the focus of heart-related concerns, right-sided chest pain can sometimes point to cardiac issues as well.

See your healthcare provider if you are experiencing chest pain, especially if it happens along with other symptoms. Getting a diagnosis is key to ensure that your right-sided chest pain is identified and treated.

This article takes a closer look at conditions that may be associated with right-sided chest pain. It also highlights the signs and symptoms of a medical emergency so that you know when to call 911.

Right-Sided Chest Anatomy

If you have pain on the right side of your chest, you may first think about what "lives" on the right side of the chest cavity, also known as the thorax.

This area is home to the following, and issues with any of these can cause right-sided chest pain:

• A portion of the right side of the heart
• The right lung
• Large blood vessels of the heart and lungs
• The esophagus, the tube that connects the throat to the stomach
• Other structures, such as lymph nodes (glands that are part of your immune system) and nerves

The ribs also lie in this region, and disorders of the spine may be felt in this region as well.

When pain that is felt on the right side does not stem from an issue with something in that specific area, it can be due to referred pain. With this, a problem occurring in a completely different part of the body puts pressure on or damages a nerve that ends up sending pain signals to the chest.

For example, upper abdominal disorders may be felt on the right side of the chest. This includes issues with the liver, gallbladder, or pancreas.

And if the diaphragm—the muscle that separates the chest from the abdomen—is irritated, this may be associated with pain in the right shoulder as well.

Right-Sided Chest Pain Symptoms

The pain experienced in the right side of the chest may come and go or be persistent. It may be an isolated incident or something more chronic.

It may also be felt in a specific area of the right side of the chest or throughout it. While some may feel it’s close to the surface, other pain may be deeply felt.

A healthcare provider will use these clues, as well as your description of the pain (“sharp,” “dull,” “throbbing,” “burning”), to help pinpoint the cause.

Other symptoms may include:

• Shortness of breath
• Fever
• Persistent cough
• Hoarseness
• Heartburn
• Unintentional weight loss
• Jaundice (yellowing of the eyes and skin)
• Nausea and vomiting
• Difficulty swallowing
• Heart palpitations (skipped beats)
• Lightheadedness
• Burping

Cardiovascular Causes

A heart attack and other cardiovascular conditions may lead to pain anywhere in the chest, including the right side. This is especially true with respect to cardiac symptoms in women.

Women having a heart attack are less likely to experience the classic left-sided chest pain and instead may note a burning sensation on either side of the chest or even no pain at all.

Other heart-related causes of right-sided chest pain include coronary artery disease, pericarditis, and a dissecting aortic aneurysm.

Coronary Artery Disease

Coronary artery disease (CAD) is the most common type of heart disease and is the leading cause of death in the United States in women and men.

It occurs when the arteries that supply blood to the heart muscle become hardened and narrowed. Some of these vessels, like the ascending aorta, are housed on the right side of the chest.

CAD may cause pain on both sides of the chest or only on the right side.

Pericarditis

Pericarditis is an inflammation of the pericardium, the protective membrane surrounding the heart.

There are many causes of pericarditis ranging from infections to cancer treatment, kidney disease to autoimmune disorders (such as rheumatoid arthritis). Pericarditis may also occur after a heart attack.

The pain is often worse in certain positions and becomes more intense with a deep breath.

Dissecting Aortic Aneurysm

A dissecting aortic aneurysm occurs when a tear in the aorta allows blood to flow between the layers of the blood vessel wall.

The aorta is the largest blood vessel. It carries blood from the heart to the rest of the body. When it is compromised by a dissecting aortic aneurysm, blood flow can be decreased to the organs, meaning they become deprived of adequate oxygen.

The pain a dissecting aortic aneurysm causes is often severe, sudden, and sharp, and may be described as tearing. Unconsciousness may follow soon after.

Perhaps best known from reports of the trauma endured by Princess Diana in the accident that led to her death, it may also occur without any trauma in people with high blood pressure or connective tissue conditions such as Marfan syndrome.

Lung-Related Causes

The three lobes of the right lung, as well as the lining of the right lung and associated lymph nodes, are located on the right side of the chest.

The lungs themselves do not have pain receptors, but you may still experience pain that seems like it is in your right lung.

Possible causes of right-sided chest pain include pneumonia, pulmonary embolism, lung cancer, collapsed lung, and fluid build-up around the lungs.

Pneumonia

Pneumonia is an infection that causes inflammation of the air sacs of your lungs called alveoli. This can cause them to fill with fluid or pus, leading to symptoms such as a cough and fever (common), as well as chills and trouble breathing.

Pneumonia, especially an infection of your right lung, can also cause pain on the right side of your chest.

Pulmonary Embolism

Pulmonary emboli occur when blood clots in the legs (called deep venous thrombosis or DVT) break off and travel to the lungs. If a clot lodges in vessels of the right lung, right-sided pain may occur.

This pain is often sudden and sharp, and it may be associated with severe shortness of breath. With large clots, unconsciousness may follow rapidly. People may or may not recall having pain, redness, or swelling in one or both legs prior to a pulmonary embolus.

Unfortunately, pulmonary emboli are very common, occurring in over half a million people each year. They are fatal around 10% of the time.

Risk factors include many chronic diseases, prolonged bed rest or surgery, and long-distance travel by plane or by car, yet a significant number of people do not have any obvious risk factors.

Lung Cancer

Tumors in the right lung, the lining of the right lung, or nearby lymph nodes can cause pain on the right side of the chest. Roughly 50% of people with lung cancer have some pain in the chest, shoulders, shoulder blades, or between the shoulder blades.

Other symptoms may be present such as shortness of breath or a persistent cough. Since lung cancer is often diagnosed in the later stages after it has spread, it is important to have any unexplained pain evaluated.

Tumors other than lung cancer may occur in the chest cavity as well, particularly lymphomas.

In addition, breast, colon, and some other cancers may spread to the lungs. This is known as secondary lung cancer.

Pneumothorax

A collapsed lung, called a pneumothorax, can cause pain on the right side of the chest. The chest pain will typically be sharp and stabbing, and will get worse when you try to breathe in.

Causes of a collapsed lung include a chest injury, lung disease, and long-term mechanical ventilation.

Pleural Effusion and Pleurisy

A pleural effusion is a build-up of fluid in the space between the membranes (pleura) surrounding the lungs. Some call it "water on the lungs." There are many possible causes.

When an effusion is small, there may only be discomfort. But with large effusions, shortness of breath is often present as well.

When the built-up fluid contains cancer cells, the condition is called a malignant pleural effusion. This can happen because of cancer that either originated in the chest (lung, breast) or spread there from elsewhere in the body. These cases can be quite painful.

Pleurisy is the inflammation of the pleura. This can often cause persistent right-sided chest pain. This pain often increases with a deep breath and can sometimes feel scratchy. Pleurisy can be caused by a pleural effusion, as well as pneumonia or severe flu.

Gastrointestinal Causes

Gastrointestinal conditions, especially those involving the esophagus or organs on the right side of the abdomen, such as the gallbladder and liver, may cause pain restricted to the right side of the chest.

Some of the conditions that cause right-sided chest pain include:

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease, also known as GERD, is a digestive disorder that affects the ring of muscle between your esophagus and stomach—the lower esophageal sphincter, or LES.

If the LES doesn't work properly, you can get heartburn or acid indigestion. You may also feel pain in the right side of the chest alone.

Esophageal Obstruction

A foreign body in the esophagus is a possible cause of right-sided chest pain that is sometimes overlooked. This is when food and another swallowed object become stuck in the esophagus.

Esophageal foreign bodies cause difficulty swallowing and can sometimes lead to tearing.

Esophageal spasms can cause right-sided chest pain. These are caused by the malfunction of the nerves that regulate the movement of the esophagus, leading to pain and coughing.

Gallbladder Disease

Both gallstones and cholecystitis (infection of the gallbladder) may be felt as right-sided chest pain.

This pain often travels through to the back and may also make its way to the right shoulder.

Pancreatitis

Pancreatitis is inflammation of the pancreas.

The pain associated with pancreatitis can be worse with lying down and better with sitting up.

People with diabetes and excess alcohol intake are at an increased risk.

Peptic Ulcer Disease/Gastritis

Both peptic ulcer disease (stomach ulcer) and gastritis (inflammation of the lining of the stomach) can cause pain that is felt on the right side of the chest, although it is more common on the left.

The pain may initially actually improve somewhat with eating.

Some people with severe gastritis compare the experience to having a heart attack, as it can also cause palpitations and shooting pain down the arm or between the shoulder blades.

Liver Disease

Liver diseases such as hepatitis and cirrhosis cause pain that is felt on the right side of the chest.

The pain mostly arises when the inflamed organ presses against the diaphragm. The pain is sometimes associated with jaundice, a yellowish discoloration of the skin and whites of the eyes.

Musculoskeletal Causes

Musculoskeletal refers to the system of bones, muscles, tendons, ligaments, and soft tissues that support the body and help you move.

With trauma, bone fractures and damage to soft tissues can cause chest pain. Without a history of trauma, there are several conditions that may also give rise to right-sided chest pain.

Some of these causes of right-side musculoskeletal chest pain include muscle strain, costochondritis, and spinal conditions.

Muscle Strain

Muscle strains are one of the more common causes of right-sided chest pain.

Many people can recall activities such as heavy lifting or a new workout program that they engaged in before developing this type of pain.

Costochondritis

Costochondritis is inflammation of the cartilage connecting the ribs to the breastbone (called the costochondral junction).

This condition is usually caused by a chronic overuse injury, so most people do not recall any specific trauma. For example, furniture movers may experience costochondritis.

The pain tends to worsen with activity or with a deep breath, and there is often tenderness when pressure is placed over the rib junctions.

A less common problem, called Tietze's syndrome, is similar but includes swelling and usually involves only one rib.

Spinal Conditions

Conditions such as spinal disc disease or compressed vertebrae may cause direct or referred pain felt on the right side of the chest. Sometimes, the spread of breast cancer or lung cancer to the spine is first noticed as pain on the right side of the chest.

Other Causes

There are several other possible causes of pain in the right side of the chest, some of which include shingles, mediastinal tumors, anxiety, and panic disorder.

Shingles

Shingles is a condition that occurs when the chickenpox virus is reactivated. If the virus has been lying dormant in nerve roots supplying the right side of the chest, pain may occur in this region.

A rash usually occurs in the distribution of the nerve roots and helps to make the diagnosis, but the pain may precede the rash by several days making the diagnosis at first difficult.

Mediastinal Tumors

Tumors or swollen lymph nodes in the the area of the chest between the lungs, called the mediastinum, can cause chest pain felt on either side of the chest. It's possible that it can occur only on the right side.

Enlargement of the mediastinal lymph nodes may occur with both Hodgkin and non-Hodgkin lymphoma, as well as the spread of lung cancer or breast cancer.

Noncancerous tumors may occur in this region.

Anxiety and Panic Disorder

About 40% of people with panic disorder experience chest pain at some time.

Noncardiac chest pain associated with panic disorder is unique in some ways, but you always want to err on the side of caution.

People who have anxiety or even panic disorder can also experience life-threatening causes of chest pain.

Diagnosis

Depending on your symptoms and other factors, there are several tests your healthcare provider may order.

But the first thing they will do is to make sure your "ABCs" (airway, breathing, and circulation) are stable. If it appears so, the doctor will review your medical history and symptoms, and then do a physical exam.

They may ask you questions such as:

• When did your pain begin?
• Is the pain widespread or located in a specific part of the body?
• Have you ever had this type of pain before?
• How would you describe this pain? Sharp? Dull? Throbbing? Crushing? Burning?
• Did the pain begin rapidly or did it come on gradually?
• Does the pain occur with activity or at rest?
• Does anything make your pain worse or better?
• Does the pain get worse with eating?
• Does the pain radiate to places like your back or jaw?
• What other symptoms do you have?
• What medical conditions do you have?
• Do you smoke or have you ever smoked?
• What medical problems run in your family?

Some conditions, such as shingles, can be diagnosed during a physical exam. Others require a more intensive investigation. This usually starts with:

• Blood tests
• Chest X-ray
  
• Electrocardiogram (EKG or ECG), which measures the electrical activity of your heart
• Magnetic resonance imaging (MRI), which uses powerful magnetic waves to image soft tissues
• Computed tomography (CT) scan, which puts together multiple X-ray images to create a three-dimensional image of the thorax

Based on these findings, other tests and procedures may be ordered. For example, an echocardiogram may be done so a practitioner can see a moving image of your heart. A cardiac stress test may be done to measure the heart's response to physical exertion.

Summary

The causes of right-sided chest pain are many and may include heart, digestive, respiratory, or musculoskeletal problems. The pain may be caused by problems in the chest cavity itself, the upper abdomen, or even nerves elsewhere in the body.

Diagnosis will involve a physical exam and a review of your medical history and symptoms. Based on the findings, other tests and procedures may be ordered, including blood and imaging tests.

Right-sided chest pain is not as likely to be related to heart disease as left-sided chest pain, but that doesn't mean it is any less serious. If your pain is severe, you're noticing shortness of breath, or you just aren't sure if what you're experiencing could be life-threatening, don't wait. Call 911.

A Word From Verywell

According to the American Heart Association, if you think you're having a heart attack, call 911 immediately. Your emergency medical team will tell you whether or not taking aspirin is advised in your case.