Left-Sided Chest Pain: Potential Causes and Why Medical Evaluation Is Crucial

Left-sided chest pain can arise from cardiac, pulmonary, gastrointestinal, musculoskeletal, or psychological origins. Self-diagnosis is dangerous.

Common Causes

System	Conditions
Cardiac	Angina, MI, pericarditis, myocarditis, aortic dissection, mitral valve prolapse
Pulmonary	Pulmonary embolism, pleuritis, pneumonia, pneumothorax
GI	GERD, esophageal spasm, hiatal hernia, pancreatitis
Musculoskeletal	Costochondritis, rib fracture, intercostal muscle strain, Tietze syndrome
Psychogenic	Panic attack, anxiety, somatic symptom disorder
Other	Herpes zoster (pre-eruptive), breast pathology, referred abdominal pain

Red Flags for Urgent Evaluation

• Pressure, squeezing, or crushing substernal/left chest pain
• Radiation to jaw, neck, left arm, back
• Associated dyspnea, diaphoresis, nausea, syncope
• Exertional onset, relieved by rest/nitroglycerin
• New-onset >40 with risk factors (HTN, DM, smoking, family history)

Diagnostic Approach

ECG, troponin, CXR, D-dimer/PE protocol, echocardiogram, stress testing, endoscopy as indicated.

Bottom Line

Any unexplained chest pain warrants professional assessment. Time is myocardium.