Is There A Connection Between Asthma And Chest Pain?

If you have asthma, you know how scary the symptoms can be. Along with its characteristic breathing issues, asthma is associated with various other serious symptoms, including chest pain. You should always take chest pain seriously. Schedule an appointment with your doctor to discuss your symptoms, even if you're confident they’re linked to asthma.

Here's what you need to know about the relationship between asthma and chest pain.

What is asthma?

Asthma is a chronic respiratory condition that causes swelling, tightening, and excess mucus production in the airways leading to the lungs. This reaction can make it difficult for air to flow to and from your lungs. Asthma symptoms, which can range in severity from annoying to life-threatening, include: 

• Shortness of breath

• Wheezing

• Coughing

• Chest pain or tightness

• Night-time coughing spells

There is no cure for asthma; however, symptoms and flare-ups can be managed (and sometimes prevented) by avoiding triggers and following an individualized asthma action plan¹ developed by a healthcare provider.

Can asthma cause chest pain?

Asthma symptoms can vary from person to person. In some cases, persistent wheezing and coughing can cause residual chest discomfort. Struggling to breathe in and out normally during an asthma attack can strain your chest muscles, leading to tightness or discomfort. If you experience chest pain, it's important to note the type of pain —  is it dull soreness or sharp pain? 

Two medical conditions associated with asthma-related chest pain are:

Pneumomediastinum

Pneumomediastinum² develops when the air leaks from the lungs or airways and becomes trapped within the space between your lungs and other organs in your chest cavity, causing severe chest pain. While this condition is rare, when it does occur, it's most common in males and young adults. In most cases, pneumomediastinum will go away on its own without the need for professional medical treatment.

However, your doctor may want to perform tests to rule out more serious causes of chest pain, and they may offer medication to ease discomfort. Chest pain caused by pneumomediastinum can radiate to other areas of your body, including your back and neck. Other possible symptoms include:

• Difficulty swallowing (dysphagia)

• Shortness of breath (dyspnea) 

• Coughing spells

• Puffiness in the face, neck, and chest caused by air underneath the skin (subcutaneous emphysema) 

• Labored breathing

• Hoarseness of the voice

Pneumothorax

In some cases, the pressure caused by pneumomediastinum can lead to pneumothorax.³ This condition develops when your lung collapses, leaking air into the area between your lungs and chest walls. There are two types of spontaneous pneumothorax: primary and secondary.

Primary spontaneous pneumothorax occurs in people with no history of lung or breathing issues. Secondary spontaneous pneumothorax develops in people with lung diseases, including asthma. Because pneumothorax can be life-threatening if left untreated, it's essential to seek emergency medical care if you experience symptoms associated with the condition. These include:

• Chest pain, which may be sharp and severe

• Shortness of breath

• Rapid heartbeat

• Breathing quickly

• Wheezing

• Agitation

• Respiratory distress

Triggers for chest pain in asthma

People with asthma are more likely to experience symptoms or a flare-up after exposure to a trigger. Asthma triggers vary; something that causes a flare-up in one person may not affect another person at all.

Recognizing your specific triggers and avoiding them whenever possible is the best way to prevent an asthma attack and its associated symptoms, including chest pain. Common asthma triggers include:

• Outdoor air pollution

• Dust mites

• Cigarette smoke

• Pet dander

• Pests, such as cockroaches  and mice

• Cleaning and disinfecting products

• Mold

• Cold, dry air

• High humidity

• Exercise

• Some foods

• Certain medications

• Fragrances, such as perfume

Signs of chest pain

Like other types of pain, chest pain can manifest differently between individuals. Knowing how to describe your chest pain can help your healthcare provider determine whether the source of your discomfort is asthma or another medical condition, such as a problem with your heart. Chest pain can take the form of:

• Tenderness

• Pressure

• Squeezing

• Fullness

• Burning

It may last for minutes, hours, or days. Sometimes, chest pain gets worse when you cough, breathe or reposition your body.

Chest pain that isn’t linked to heart troubles is typical:

• Sharp or stabbing and may be worse when you cough

• Limited to one side of the body or one small area of the chest

• Worse when you apply pressure to the area

• Pain that lasts for many hours or days without any other symptoms

Chest pain that is specifically heart-related and requires urgent medical attention is signaled by: 

• Burning, pressure, squeezing, or tightness in your chest

• Pain that extends to the left arm, neck, jaw, or back

• Heaviness, weakness, or aching in one or both arms that comes on suddenly

• Shortness of breath

• Sudden nausea or vomiting

• Dizziness or feeling lightheaded 

• Hot flashes or cold sweats

• Unusual tiredness

Whether your chest pain is uncomfortable but bearable or utterly debilitating, you shouldn’t ignore it. Chest pain can indicate a serious medical condition. For this reason, if your chest pain lasts more than a few minutes, don't try to guess the cause. Instead, contact your healthcare provider right away.

Causes of chest pain

Chest pain is the second leading cause of emergency room visits and accounts for around 5% of all cases. Because chest pain is so common, it can be challenging to pin down the cause. Causes of chest pain can range from mild to life-threatening and include:

• Asthma

• Pneumomediastinum

• Pneumothorax 

• Muscle, tendon, or bone-related issues 

• Chest injury

• Gastrointestinal reflux disease 

• Pleurisy

• Panic attack

• Heart attack

• Blood clot in the lung

• Suddenly reduced blood flow to the heart

• Pericarditis (swelling of the tissue around the heart)

• Pneumonia 

• Pulmonary hypertension

Preventing asthma-related chest pain

If you're diagnosed with asthma, your healthcare provider will likely create an asthma action plan to suit your particular needs. This plan may include lifestyle changes that keep your asthma symptoms under control, such as avoiding your asthma triggers. 

In some cases,  the anxiety caused by an asthma flare-up can worsen symptoms (including chest tightness). Because of this, it's a good idea to prevent your asthma symptoms from progressing as soon as you notice them developing. The following tips may help you improve or prevent asthma chest pain:

• Breathe slowly: Focus on breathing slowly to prevent hyperventilation.

• Breathe deeply: Once you're breathing slowly, take deeper breaths (aim for eight-second inhales and exhales). 

• Improve your posture: If you're slouching over, it can be difficult for air to fill your lungs. Sit up straight to make your breathing more efficient. 

• Take your medication: Don't wait to take your rescue inhaler if you're experiencing asthma symptoms. Taking your medication sooner than later can prevent symptoms from becoming worse and harder to control.

Treating asthma-related chest pain

Treatment options for chest pain depend on its cause. If you're experiencing chest pain due to asthma, there are a variety of treatment options to get your asthma under control and improve symptoms. Some medications provide quick relief in the event of an asthma attack, while others improve long-term control of the condition. Common asthma medications include:

• Bronchodilators:⁴ Inhaled medications are used during asthma attacks to relax the constricted muscles in your airway and help clear out mucus so air can flow more freely.

• Omalizumab: Injected medication that helps control the inflammation that can cause or exacerbate an asthma attack. 

• Reslizumab: Injected maintenance medication that’s taken in combination with other medications to help control asthma symptoms in patients 18 or older. 

When to see a doctor

Whether you're experiencing an asthma attack or unexplained chest pain, it's important to address your condition immediately. Don't wait to seek emergency medical care if your asthma symptoms do not respond to your prescribed medications or the steps recommended in your asthma action plan.

Likewise, if your chest pain is persistent, gets worse over time, or is accompanied by other severe symptoms, such as shortness of breath, seek emergency medical care as soon as possible. 

The lowdown

Asthma can cause many different symptoms, including chest pain, that may be misdiagnosed as other conditions. Recognizing your asthma triggers and knowing how to describe your chest pain can help your healthcare provider determine if your chest pain is caused by asthma or another health condition.

Taking your medications and following the asthma action plan recommended by your healthcare provider is the best way to keep your symptoms under control and prevent them from progressing into an asthma attack. However, if you do experience asthma symptoms, including chest tightness or discomfort, don't hesitate to seek treatment.