Chest pain isn’t on the Center for Disease Control and Prevention’s (CDC) official list of COVID-19 symptoms, but that doesn’t mean it can’t be a marker of the respiratory illness, especially because the agency notes that the list isn’t all encompassing.
That means other symptoms and side effects of the virus that have been reported by patients—such as a skin rash, hair loss, and, yes, chest pain—shouldn’t be ruled out as a potential sign of a novel coronavirus infection. In fact, many people have reported feeling chest pain during their COVID-19 experience on social media. One Twitter user wrote “Awful chest pain, debilitating headache, and a cough that has returned that takes everything out of me. Covid, you have wiped me out.”
Another said: “Day 163 post COVID: I managed to walk for 20 mins without chest pain while keeping my heart rate below 120...slowly the light starts to appear at the end of an almost 6 month long tunnel.”
Doctors have seen it, too. Patients “sometimes complain of chest pain from coughing,” says Richard Watkins, M.D., an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University. Here’s what you need to know about chest pain as a possible symptom or side effect of COVID-19, what it can mean, and when to see your doctor it.
What are the “official” symptoms of COVID-19?
Here’s what the CDC currently lists as the main symptoms of COVID-19:
Fever or chills
Shortness of breath or difficulty breathing
Muscle or body aches
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting
Is chest pain a common symptom of COVID-19?
While chest pain isn’t on the CDC’s list of COVID-19 symptoms, it’s listed as a “serious symptom” of the virus by the World Health Organization (WHO), along with difficulty breathing, shortness of breath, chest pressure, and loss of speech of movement. The WHO recommends that you “seek immediate medical attention” if you experience any of those symptoms.
Dr. Watkins adds that, while chest pain can occur in COVID-19 patients, it is “not a frequent symptom” so far. One July report from the CDC found that 35% of 164 confirmed COVID-19 patients reported feeling chest pain or discomfort after testing guidelines were expanded on March 8.
Why does COVID-19 sometimes cause chest pain?
Not everyone with COVID-19 will have chest pain but it’s “not surprising” that someone might experience it, says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. He says there are a few reasons why COVID-19 could cause chest pain:
You’ve been coughing violently. “That can cause muscles to tear and ribs to break,” Dr. Adalja says.
You have pneumonia, which can be a complication of COVID-19.
Your lungs are inflamed or infected, and that alone can cause chest pain, Dr. Adalja says.
You have a pulmonary embolism, which happens when a blood clot breaks loose and travels through the bloodstream to the lungs, per the National Institutes of Health (NIH). That can restrict blood flow to the lungs and even be deadly. Research has found that COVID-19 patients are at an increased risk of pulmonary embolisms, Dr. Adalja points out.
What does chest pain due to COVID-19 feel like?
Chest pain linked to COVID-19 can feel a little different, depending on what’s causing it. “If it’s because of a rib fracture, it could be very sharp pain and the area could feel tender to the touch,” Dr. Adalja says. But if it’s due to muscle strain, you could have sharp pain that’s worsened by movement, he says.
Chest pain from coughing often feels like “general soreness around the chest,” adds Shobha Swaminathan, M.D., an associate professor of medicine at Rutgers New Jersey Medical School.
If pneumonia is behind your chest pain, you may only feel uncomfortable when you take deep breaths, Dr. Adalja says.
Experiencing chest pain on its own doesn’t automatically mean you have COVID-19.
Chest pain can be a symptom of many different things, ranging in severity from anxiety to pulling a muscle in the area to struggling with a lung or heart condition. “If you have chest pain, it could be your heart, some other lung problem, it could be musculoskeletal, it could be the esophagus—it could be a lot of different things,” says Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, Calif.
Plus, Dr. Adalja says “it’s unlikely that you would just have isolated chest pain with COVID-19.” Instead, you would probably have chest pain along with a cough, fever, and other upper respiratory symptoms.
“If you have minor chest pain and it’s associated with fever, loss of smell, and a cough, maybe it is COVID-19,” Dr. Casciari says, adding that if you have chest pain with no other symptoms, then you should go to a doctor because it’s likely something else.
It’s also important to note that if you have a known risk for heart disease, Dr. Adalja says that it’s important to “consider that you might be having a heart attack” if you experience unusual chest pain.
Even if you’re not considered high risk for heart disease, sudden chest pain is definitely not something you want to ignore. “Knowing what’s causing the chest pain would really drive the recommendation,” Dr. Swaminathan says. “We have to make sure that we’re not missing a heart attack.” When in doubt, see your doctor ASAP.
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