Right-sided chest pain is usually felt as a result of non-urgent conditions, like a muscle strain, acid reflux, or even excess stress.

However, noticing pain on the right side of the chest can also be a sign of a serious problem in the digestive system, lungs, and even the heart. Therefore, any time you feel any chest pain, you should be promptly assessed and treated as needed.

If your right chest pain occurs frequently, is very intense, worsens with time, or if it occurs with other symptoms such as tingling in the arm and face, difficulty breathing, or fainting, call an ambulance or proceed to a hospital immediately. These symptoms can be a sign of a life-threatening condition, such as a heart attack.

What causes right side chest pain?

The most common causes of right-sided chest pain include:

1. Stress and anxiety

Excess stress and anxiety are two conditions that can lead to a panic attack, and they can cause very similar symptoms to a heart attack, like sudden chest pain. Usually the pain is felt more in the middle of the chest with a panic attack, but many times it can radiate to the right side of the body.

Along with chest pain, other symptoms that can emerge are shallow breathing, breathlessness, tingling in the hands and feet, and sweating. Unlike a heart attack, a panic attack is more common after a very stressful situation and the chest pain tends to disappear within a few minutes.

What to do: The best way to alleviate discomfort caused by a panic attack is to try to calm down by regulating your breathing relaxing any tense muscles. It might help to go somewhere quiet and drink a cup of valerian or chamomile tea. If the chest pain is still strong or if you suspect a heart attack, call an ambulance or go to the hospital immediately.

Check out the herbs for anxiety and stress that can be used for soothing, sedative teas.

2. Muscle strain

A strained muscle is another common cause of right-sided chest pain and it usually happens one or two days after performing any activity that uses the chest muscles more intensively. These activities can be intentional (e.g. exercising at the gym), or unintentional (e.g. painting a ceiling).

Using strong force in the chest region can cause temporary damage to muscle fibers, and although this may not cause pain immediately, it may become painful after a few days. Other symptoms of strained chest muscles include increased pain with palpation, slight swelling, and difficulty moving your arms.

What to do: Applying ice to the affected region for 15 to 20 minutes, three to four times a day, will help with pain relief. Also, you can do a light massage over the affected region with an anti-inflammatory cream. If the pain does not improve within three days, assessment by a general physician or a physiotherapist is recommended, as more specific treatment may be needed.

3. Acid reflux (or GERD)

Acid reflux, also known as heartburn or gastroesophageal reflux disease (GERD), is a common condition that occurs when stomach acid travels up the esophagus, causing a burning sensation (particularly after eating). This discomfort can sometimes be painful, and can be felt in the general chest area or on the right side.

GERD is generally accompanied by other symptoms such as a frequent need to burp, a bitter taste in the mouth, feeling like there’s a lump in the throat, and a dry cough.

What to do: Depending on the severity, reflux symptoms can be relieved through simple diet changes, such as avoiding large meals and avoiding fatty and spicy foods. However, there are cases where medication to block stomach acid may be necessary. If the discomfort does not improve with diet changes, a consult with a gastroenterologist is recommended to start adequate treatment.

4. Costochondritis

Costochondritis is a less common problem but it can cause intense chest pain. Typically pain is felt in the middle of the chest, but it can radiate to the right or left side.

This condition happens when the cartilage that connects the sternum to the ribs becomes inflamed due to strong pressure changes, intense coughing, or even bad posture. Costochondritis causes sensitivity in the mid-chest area, and pain usually worsens when you cough or take a deep breath.

What to do: Costochondritis is a temporary problem that tends to improve after a few days without any specific treatment. However, stretching exercises and applying ice to the affected area for 15 to 20 minutes, three to four times a day, can decrease inflammation and relieve discomfort. Anti-inflammatory medication may also help with swelling.

5. Gallbladder inflammation

The gallbladder is an organ in the abdominal cavity that is located in the upper right side. It can become swollen if gallstones start to accumulate within the organ, if a gallstone blocks a duct, or following the digestion of a high-fat meal.

Inflammation can cause pain in the upper right abdomen that radiates up to the right chest. Other symptoms include vomiting, nausea, fever and yellow diarrhea.

What to do: If you suspect you may have gallbladder inflammation, you are advised to see your family doctor or gastroenterologist for assessment. You should proceed to the hospital if you experience intense right-side pain and nausea with frequent vomiting. This inflammation is usually treated with plenty of fluid (taken orally or administered IV) as well as antibiotics and analgesics.

6. Liver inflammation

The liver, like the gallbladder, is also located in the upper right abdomen. Swelling of this organ is typically triggered by an infection, over-consumption of toxic substances (like medication or alcohol), parasites or other heart problems. Learn more about the most common causes of liver inflammation.

Inflammation can cause upper right abdominal pain that radiates to the right side of the chest, as well as vomiting, loss of appetite, general malaise, and jaundice. You can read more about symptoms specific to liver disease here.

What to do: Treatment for liver diseases usually varies depending on the underlying cause of inflammation. It may involve suspending medication or alcohol intake, as well as specific interventions to manage infections, for example. It's also important to maintain a well balanced diet, that includes the consumption of fresh fruits and vegetables.

7. Pneumonia

Pneumonia is characterized as lung inflammation caused by infectious agents, aspiration of food or use of unsanitary breathing equipment. This condition is most common in children under the age of five and older adults over 70, as these populations tend to have lower immunity.

Pneumonia symptoms can appear gradually or happen quickly, specially when the immune system is weakened. The most common symptoms of pneumonia include back or chest pain (which can be felt on the right side, left side, or both), difficulty breathing, fever and cough.

What to do: You should see a doctor if you feel that your breathing is compromised and you are experiencing a fever. The doctor will assess your chest through ausculation and order a chest x-ray to better visualize the lung fields. Treatment for pneumonia depends on the underlying cause, and may involve antivirals, antibiotics and analgesics.

8. Pneumothorax

A pneumothorax is a condition associated with air in the pleural space, which is the space between the chest wall and the lung. Having air in this space increases pressure on the lung, causing the lung to collapse. A collapsed lung on the right side of the chest can lead to pain in the area, as well as severe difficulty breathing, coughing, and pain with breathing.

This condition is more common following a chest injury, like after a fall or perforation, however it can occur as a consequence of pneumonia or asthma.

What to do: If you suspect you suffered a pneumothorax, you should go to the hospital immediately for testing and to confirm a diagnosis. Treatment is aimed at removing the excess air and relieving pressure on the long, and usually involves the aspiration of the air with a needle.

9. Pulmonary embolism

A pulmonary embolism is a lung condition that is characterized by blood clot blocking a blood vessel in the lungs. It leads to decreased blood flow to the area, meaning less oxygen and possible tissue ischemia. This condition can cause right side chest pain if the clot is located in the right lung, as well as symptoms like shortness of breath, coughing, chest pain, dizziness and excess sweating.

Pulmonary embolisms can occur with conditions like heart disease, cancer, surgery, clotting diseases or COVID-19.

What to do: A pulmonary embolism is a life-threatening condition, therefore you should proceed immediately to a hospital if you notice the above symptoms

10. Heart problems

When you get any chest pain, one of the main concerns is that it may be a sign of a heart problem. Although, it is not very common for right-sided chest pain to be caused by the heart, it is possible for heart problems to cause pain that radiates to the right side, especially if the heart muscle is inflamed.

Heart problems are more commonly seen in elderly people, people with other chronic problems or patients who are hospitalized for serious infections. Heart-specific pain is usually very intense and causes a sensation of tightness in the chest. Additionally, other symptoms can occur, like palpitations, cough, difficulty breathing and fainting. Take a look at the symptoms of heart disease that you shouldn’t ignore.

What to do: If you suspect that your chest pain is related to a heart problem, proceed to the hospital or call for an ambulance immediately, so that a diagnosis can be confirmed and treatment can be started.

When to go to the doctor

Many times, right-sided chest pain disappears after a few minutes and if it does, there’s no reason to worry. However, assessment by a doctor is the only way to really identify the underlying cause. It's best to go to a hospital if:

The pain is very intense or gets worse with time
The pain lasts for more than 15 minutes
Other symptoms appear such as difficulty breathing, fever or fainting

In addition, elderly people and those with chronic problems, especially respiratory or heart disease, should be assessed by a doctor, as the pain may indicate that the condition has worsened, and treatment may need to be adjusted.