Chest pain on the right side can have many possible causes, ranging from mild to serious. Because chest pain can signal a potentially dangerous condition, it’s important to evaluate intensity, accompanying symptoms, and your risk factors. Here’s a practical guide to what might be happening and when to seek urgent care. What common causes people notice on the right side
- Musculoskeletal causes: Muscle strain from lifting, overexertion, or coughing; rib or chest wall irritation; costochondritis (inflammation where ribs meet the breastbone). These typically worsen with movement, deep breaths, or pressing on the area, and often improve with rest or NSAIDs as advised by a clinician.
- Digestive/gastrointestinal causes: Acid reflux or heartburn, gallbladder issues (often right upper abdomen radiating to the chest, especially after fatty meals), or esophageal spasm. Symptoms may include a burning sensation, belching, or nausea.
- Lung and airway causes: Pneumonia, bronchitis, a viral illness, pneumothorax (collapsed lung) or a pulmonary embolism (blood clot). These can present with coughing, shortness of breath, fever, or sudden sharp chest pain, sometimes with rapid breathing or faintness.
- Heart-related causes (less commonly right-sided alone): While many heart-related pains are centered in the center or left chest, it’s possible to have atypical presentations. Conditions like pericarditis or a heart attack usually present with pressure, tightness, sweating, shortness of breath, nausea, or pain spreading to the arm, jaw, or back.
Red flags that require immediate medical attention
- Sudden, severe chest pain or chest pain with trouble breathing, fainting, confusion, or sweating
- Chest pain after injury with difficulty breathing or deformity
- Pain with leg swelling, unilateral leg redness, or shortness of breath suggesting a possible blood clot
- Pain accompanied by fainting, severe weakness, confusion, or an inability to stay conscious
What to do right now
- If the pain is new, severe, or accompanied by shortness of breath, fainting, dizziness, sweating, nausea, or arm/jaw pain, call emergency services or go to the nearest emergency department.
- If the pain is mild to moderate and you’re not sure of the cause, consider:
- Resting and avoiding strenuous activity for a while
- Noting any triggers (recent meals, physical strain, or anxiety) and symptoms (fever, cough, wheezing)
- Trying an over-the-counter pain reliever only if you have no contraindications (e.g., no ulcers, kidney disease, or allergy; follow label directions)
- Checking in with a clinician for a broader assessment if symptoms persist beyond a few days, worsen, or recur
When to seek care soon (within 24 hours)
- Chest pain with persistent shortness of breath, dizziness, or fainting
- Chest pain with a fever, productive cough with colored mucus, or coughing up blood
- Pain that doesn’t improve with rest or that worsens over time
- Known risk factors for heart or lung disease (e.g., tobacco use, high blood pressure, high cholesterol, diabetes, prior cardiovascular events)
Possible next steps your clinician may take
- A focused history and physical exam, including pulse, blood pressure, and lung/heart sounds
- ECG to assess heart rhythm and potential ischemia
- Blood tests for heart enzymes if heart involvement is suspected
- Chest X-ray or ultrasound if a lung or rib condition is suspected
- Consideration of abdominal exam if gallbladder or GI issues are suspected
- If indicated, further imaging or referral to a specialist
If you’d like, share more details about your pain (location, quality—sharp vs dull, duration, triggers, any accompanying symptoms like shortness of breath, nausea, sweating, or fever), your age and any medical history. This can help clarify potential causes and whether urgent evaluation is advisable.
