Whilst it is understandable to panic when experiencing chest pain, the NHS reports that most chest pains are not caused by heart-related issues.1 Chest pain during and after exercise can be caused by a wide range of factors and can affect everyone, even those in perfect health. In the following article, we will take an in-depth look at:
- The most common causes of chest pain
- When you should see a doctor
- The more severe symptoms
- How we can help prevent chest pain during and after exercise
Causes of Chest Pain During and After Exercise
Whilst some cases of chest pain are caused by heart-related issues, some of the most common causes of chest pain during and after exercise are not related to our heart. We will discuss some of the most common heart and non-heart-related causes of chest pain.
Trauma and Inflammation
Research indicates that both trauma and inflammation can cause chest pain.2,3 Trauma to your chest is normally caused by a forceful blow or impact, causing potential damage to bones, muscles, and blood vessels.
Certain physiological responses to exercise, such as heavy breathing, can increase the level of pain we experience at the site of the trauma.
Inflammation within the chest can occur due to several reasons, including injuries, continuous repetitive intense physical activity, and medical conditions (e.g. costochondritis).4
Moreover, research has shown certain intense exercises can aggravate inflammation.5 As inflammation increases, swollen tissue begins to press against our nerve endings, causing chest pain during and after exercise.
Gastrointestinal (GI) problems, such as irritable bowel syndrome, gastroesophageal reflux disease (GERD) and gallstones, can all cause us to experience chest pain during physical activity.
Research indicates that ‘strenuous exercise’ can have a temporarily adverse effect on our gastrointestinal tract, potentially inducing illness, cramping, acid reflux, bloating and heartburn, all of which can cause us to experience chest pains.6 Those suffering from GI problems are reportedly at the highest risk of suffering from these adverse effects, increasing their chance of suffering from chest pain during physical activity.
Respiratory issues, especially in our lungs, can also cause us to experience pain during and after exercise. Chest pain caused by respiratory conditions is normally due to a medical condition. Some examples of these medical conditions include:
- Exercise-induced Asthma – Exercise can trigger inflammation within the airways of those who suffer from asthma, causing breathing difficulties and chest pain.7
- Exercise-induced Bronchospasm (EIB) – Research has found EIB to be the most common cause of chest pain during exercise.8 EIB is a spasm that occurs in the airways of the lungs during exercise. EIB symptoms include sharp chest pain and difficulty breathing.
- Pulmonary Embolism – A condition where a blood clot develops in one of the pulmonary arteries. Physical activity can lead to a sharp increase in the chest pain experienced by those suffering from the condition.
Cardiovascular Changes in Athletes
According to a study published in the British Medical Journal, athletes are twice as likely to develop arterial fibrillation, a condition that causes irregular heartbeat and limits blood flow to the heart muscles.9 As a result of these symptoms, the condition can cause chest pains. Whilst extremely rare in athletes, the immediate cardiovascular changes that occur during high-intensity exercises, such as weightlifting, can cause an aortic dissection.10, 11
Moreover, during intense physical activity, a sudden rise in blood pressure occurs. Over time, regular bouts of high blood pressure can weaken the walls of our aorta (the body's largest artery), which can eventually cause tears to develop, potentially allowing blood to escape through the walls.
For some individuals, chest pains during exercise will be due to a heart problem. Of course, the term ‘heart problems’ is extremely broad. Below are some of the most common heart problems that can cause chest pain during and after exercise.
- Heart attack – Whilst rare, heart attacks can occur during physical activity, causing sharp chest pains. A heart attack occurs when heart tissue begins to die due to a lack of oxygenated blood flow.
- Angina pectoris – Angina pectoris is the chest pain we experience when we are affected by coronary artery disease, a condition where blood flow to the heart is restricted as a result of blocked arteries.
- Hypertrophic cardiomyopathy (HCM) – Hypertrophic cardiomyopathy is a condition where our cardiac muscle becomes thicker than it should. As a result, the heart’s chambers become narrower and much thicker, meaning they are unable to hold and pump as much blood.
What to do if you have Chest Pain after Exercise
When to See a Doctor
Whilst most chest pains are not a sign of a serious condition, it is always safer to visit your local GP for a check-up if you suffer from any of the following:
- Regular chest pain that comes and goes
- Short bouts of chest pain
- Abnormal heartbeat
- Worsening of existing chest pain
If you suffer from any of the following symptoms, contact 999 immediately as you may be suffering from a heart attack. Symptoms of a heart attack include:
- Chest pain that began with nausea and/or struggling to breathe
- Chest feels tight or heavy
- Pain spreads to arms, jaw, and back
- Chest pain lasts longer than 15 minutes
Prevention and Precautions
Unfortunately, not all chest pains are preventable, and some individuals may experience them in some form throughout their life. However, certain lifestyle factors can help reduce the risk of suffering from chest pains during and after physical activity.
- Perform 150 minutes of moderate to intense aerobic exercise weekly
- Consume a healthy and balanced diet
- Minimise or avoid alcohol consumption
- Avoid smoking/drug usage
- Take medication if prescribed
The WHO reports that 80% of heart attacks are preventable, whether that be by simply visiting the local GP or leading a healthier lifestyle.12 Even if the chest pain you experience is not considered life-threatening, your local GP may be able to help identify the cause of the pain, allowing you to make lifestyle adjustments and lead a life without chest pain.
- ‘Chest Pain’. Nhs.Uk, 18 Oct. 2017, https://www.nhs.uk/conditions/chest-pain/
- Johnson, Ken, and Sassan Ghassemzadeh. ‘Chest Pain’. StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK470557/
- Schumann, Jessica A., et al. ‘Costochondritis’. StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK532931/
- Costochondritis’. Nhs.Uk, 18 Oct. 2017, https://www.nhs.uk/conditions/costochondritis/
- Cerqueira, Érica, et al. ‘Inflammatory Effects of High and Moderate Intensity Exercise—A Systematic Review’. Frontiers in Physiology, vol. 10, 2020. Frontiers, https://www.frontiersin.org/article/10.3389/fphys.2019.01550
- de Oliveira, Erick Prado, and Roberto Carlos Burini. ‘The Impact of Physical Exercise on the Gastrointestinal Tract’. Current Opinion in Clinical Nutrition and Metabolic Care, vol. 12, no. 5, Sept. 2009, pp. 533–38. PubMed, https://doi.org/10.1097/MCO.0b013e32832e6776
- Gerow, Marie, and Paul J. Bruner. ‘Exercise Induced Asthma’. StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK557554/
- Molis, Marc A., and Whitney E. Molis. ‘Exercise-Induced Bronchospasm’. Sports Health, vol. 2, no. 4, July 2010, pp. 311–17. PubMed Central, https://doi.org/10.1177/1941738110373735
- Newman, William, et al. ‘Risk of Atrial Fibrillation in Athletes: A Systematic Review and Meta-Analysis’. British Journal of Sports Medicine, vol. 55, no. 21, Nov. 2021, pp. 1233–38. bjsm.bmj.com, https://doi.org/10.1136/bjsports-2021-103994
- Singh, Balraj, et al. ‘Aortic Dissection in a Healthy Male Athlete: A Unique Case with Comprehensive Literature Review’. Case Reports in Cardiology, vol. 2016, 2016, p. 6460386. PubMed Central, https://doi.org/10.1155/2016/6460386
- Ahmadi, Hossein, et al. ‘Aortic Dissection Type I in a Weightlifter with Hypertension: A Case Report’. Cases Journal, vol. 1, Aug. 2008, p. 99. PubMed Central, https://doi.org/10.1186/1757-1626-1-99
- Cardiovascular Diseases: Avoiding Heart Attacks and Strokes. https://www.who.int/news-room/questions-and-answers/item/cardiovascular-diseases-avoiding-heart-attacks-and-strokes. Accessed 24 Mar. 2022
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