What Causes Chest Pain and Shortness of Breath?

Chest pain and shortness of breath are two of the most alarming symptoms a person can experience. They often happen together, and while sometimes they stem from something minor—like overexertion or anxiety—they can also signal life-threatening conditions such as a heart attack or pulmonary disease. 

At Colorado Springs Cardiology, we frequently see patients who come in worried about these exact issues. Understanding what’s behind chest pain and shortness of breath is critical for protecting your health and knowing when it’s time to seek immediate medical attention. 

 

Why Chest Pain and Shortness of Breath Often Occur Together 

The heart and lungs work closely to deliver oxygen-rich blood throughout your body. When something interferes with either system, the result can be both chest discomfort and difficulty breathing. For example, a blocked coronary artery can reduce blood flow, causing pain in the chest while also depriving the body of oxygen, leaving you short of breath. 

These symptoms are especially concerning in older adults or people with risk factors like high blood pressure, high cholesterol, smoking, or diabetes. But they can affect anyone, which is why it’s important not to ignore them. 

 

Cardiac Causes of Chest Pain and Shortness of Breath 

Since we specialize in heart health, let’s begin with the most common cardiac-related reasons for these symptoms.

1. Coronary Artery Disease (CAD)

CAD occurs when plaque builds up in the coronary arteries, narrowing them and limiting blood flow to the heart. This can cause angina—chest pain that worsens with exertion and improves with rest. Angina often comes with shortness of breath because the heart is working harder than it should.

2. Heart Attack (Myocardial Infarction)

A heart attack happens when a coronary artery becomes completely blocked, stopping blood flow to part of the heart muscle. Symptoms include: 

  • Severe chest pain or pressure (often described as “an elephant sitting on the chest”) 
  • Shortness of breath 
  • Sweating, nausea, or dizziness 

This is a medical emergency. Call 911 immediately if you suspect a heart attack.

3. Heart Failure

When the heart can’t pump efficiently, fluid can back up into the lungs, leading to congestive heart failure. Patients may feel persistent shortness of breath, especially when lying flat, along with chest discomfort, fatigue, and swelling in the legs or ankles.

4. Arrhythmias

Abnormal heart rhythms, such as atrial fibrillation, can reduce how effectively the heart pumps blood. This can result in chest fluttering or discomfort along with shortness of breath, especially during physical activity. 

Pulmonary (Lung-Related) Causes 

Sometimes, the cause of chest pain and shortness of breath lies in the lungs rather than the heart.

1. Pulmonary Embolism (PE)

A pulmonary embolism occurs when a blood clot travels to the lungs, blocking blood flow. This can cause sudden chest pain, shortness of breath, rapid heartbeat, and coughing up blood. PE is life-threatening and requires immediate medical treatment.

2. Chronic Obstructive Pulmonary Disease (COPD)

COPD, which includes emphysema and chronic bronchitis, makes it difficult to breathe due to damaged airways. People with COPD often report chest tightness along with progressive shortness of breath, particularly with exertion

3. Pneumonia or Infection

Lung infections can cause sharp chest pain, fever, and difficulty breathing. Fluid or inflammation in the lungs makes it harder to exchange oxygen, leaving patients short of breath. 

Other Causes Beyond the Heart and Lungs 

Not all cases of chest pain and shortness of breath are tied to heart or lung problems. Sometimes the cause is less obvious.

1. Anxiety and Panic Attacks

Anxiety can mimic heart problems. Panic attacks often cause chest tightness, rapid heartbeat, and difficulty catching your breath. While not life-threatening, these episodes can feel overwhelming and frightening.

2. Musculoskeletal Issues

Muscle strain, rib injuries, or inflammation in the chest wall (costochondritis) can lead to localized chest pain that worsens with movement or deep breaths.

3. Gastroesophageal Reflux Disease (GERD)

Acid reflux can create a burning sensation in the chest that may be mistaken for heart pain. Sometimes it’s accompanied by a feeling of breathlessness, especially if reflux reaches the throat.

4. Obesity and Deconditioning

Excess weight and lack of physical fitness can cause exertional shortness of breath and chest discomfort during even mild activity. Over time, these factors also increase the risk of developing heart disease. 

When to Seek Emergency Care 

Because these symptoms can indicate a serious, life-threatening problem, it’s important to know the warning signs. Call 911 or seek emergency care immediately if you experience: 

  • Sudden, severe chest pain or pressure 
  • Pain spreading to the jaw, neck, or arm 
  • Shortness of breath at rest or worsening rapidly 
  • Dizziness, fainting, or cold sweats 
  • Coughing up blood 

Even if symptoms turn out to be minor, it’s always better to err on the side of caution. 

Diagnosis: How Doctors Determine the Cause 

At Colorado Springs Cardiology, we use advanced diagnostic tools to uncover the cause of chest pain and shortness of breath. Depending on your symptoms, tests may include: 

  • Electrocardiogram (ECG): Measures heart rhythm and detects signs of heart attack. 
  • Echocardiogram: Ultrasound imaging of the heart to check structure and function. 
  • Stress Test: Evaluates how the heart performs under physical exertion. 
  • Chest X-ray or CT Scan: Looks for lung problems or fluid around the heart. 
  • Blood Tests: Detect markers of heart damage or clotting disorders. 

The goal is to rule out life-threatening conditions quickly and create a plan for treatment. 

Treatment Options 

The right treatment depends on the underlying cause: 

  • Cardiac Issues: Medications, stents, bypass surgery, or lifestyle changes. 
  • Pulmonary Issues: Blood thinners for clots, antibiotics for infections, inhalers for COPD. 
  • Other Causes: Acid reflux medications, anxiety treatment, or physical therapy for muscle injuries. 

In all cases, addressing risk factors like smoking, high blood pressure, and poor diet is essential for long-term health. 

Preventing Chest Pain and Shortness of Breath 

While not every case can be prevented, many risk factors are within your control. Protecting your heart and lungs involves: 

  • Eating a heart-healthy diet rich in fruits, vegetables, lean proteins, and whole grains 
  • Staying active with regular exercise (with your doctor’s approval) 
  • Quitting smoking and avoiding secondhand smoke 
  • Managing stress through relaxation techniques 
  • Keeping blood pressure, cholesterol, and diabetes under control 

At Colorado Springs Cardiology, we encourage preventive care as much as treatment. Catching potential issues early can save lives (Colorado Springs Cardiology Services).  

The Role of a Cardiologist 

If you’ve ever experienced chest pain or shortness of breath, even if the symptoms went away, it’s wise to follow up with a cardiologist. We can help determine whether your heart is healthy and provide strategies to reduce future risks. 

Our team is committed to guiding patients in Colorado Springs and the surrounding area toward better heart health. Whether you need diagnostic testing, ongoing management, or preventive care, we’re here to help. 

Final Thoughts 

Chest pain and shortness of breath are symptoms you should never ignore. While they sometimes have harmless explanations, they can also point to serious heart or lung conditions that require immediate care. 

At Colorado Springs Cardiology, we provide expert evaluation and treatment for patients facing these concerning symptoms. If you or a loved one has experienced chest pain or shortness of breath, don’t wait—schedule an appointment today to take charge of your heart health.