Chest pain isn’t typically caused by obesity on its own. If you’re experiencing chest pain, it could be a sign of a heart-related problem and should be checked by a health care provider. In many cases, chest pain turns out to be caused by something less serious — but it’s still important to pay close attention to this symptom.

Chest pain is often the first and most noticeable sign of a heart attack. A heart attack happens when blood flow to the heart becomes blocked or severely reduced. Without treatment, it can lead to long-term heart damage or can be life-threatening. If your chest pain comes with symptoms such as sweating, dizziness, nausea, shortness of breath, or pain in your arm, back, or neck, seek medical care right away.

Can You Have Chest Pain With Obesity?

A member asked, “Can you have chest pain with obesity?” The short answer is yes — people with obesity can have chest pain, just like people without obesity. There are many possible causes of chest pain. Some of them are serious, and some of them might be temporary or nothing to worry about. It’s important to seek medical care when you have chest pain, since it can be caused by heart disease or a heart attack.

Obesity and Heart Disease Risk

People with obesity have a higher risk of cardiovascular disease. Several kinds of heart-related issues can cause chest pain, and all pose serious risks to your health if you have them.

Obesity increases your risk of heart disease in a few key ways.

Obesity Can Cause Conditions That Lead to Heart Disease

People with obesity have an increased risk of:

• High blood pressure
• High cholesterol
• Diabetes

All three of these conditions are risk factors for heart disease. When you have obesity, stored energy is kept as fat and causes chemicals to be released that cause inflammation in your body. It also causes the buildup of sugar and fat in your blood that increases your blood pressure, making your heart work harder. This fatty buildup in your blood (also called high cholesterol) can form deposits inside your blood vessels that block or restrict blood flow to your heart. This buildup can also turn into a blood clot that damages your heart muscle.

Having excess weight can make it harder to regulate your blood sugar and harm the way your body uses insulin. This puts you at risk of developing type 2 diabetes, which is a major risk factor for heart disease. According to the American Heart Association, people with diabetes have double the risk of heart disease and stroke.

Excess Body Weight Stresses Your Heart Muscle

When you have a higher body weight, your heart and cardiovascular system have to work harder to pump and circulate blood around your body. This extra work stresses the heart muscle and can damage it over time. Even in people who don’t have high blood pressure, high cholesterol, or diabetes, obesity is still linked to increased rates of heart disease.

Scientists know that obesity causes damage to the heart because they’ve studied a certain enzyme that only comes from damaged heart cells. Doctors can measure how much of this enzyme, called troponin, you have in your blood to see if any of your heart cells are damaged. In a study published in the Journal of the American College of Cardiology: Heart Failure, researchers tested nearly 10,000 people for troponin, measured their body mass index (BMI), and then tracked their health over time. They found that people with the highest BMI also had the highest levels of troponin and were much more likely to experience heart failure than others.

Pulmonary Embolism

Pulmonary embolism is a blood clot that lodges in a blood vessel to the lungs. This is a very serious cause of chest pain. It can lead to low oxygen levels, lung damage, and heart strain. People with obesity have a higher risk of developing pulmonary embolism.

Most blood clots are formed in the legs and may manifest as swelling, pain, or discoloration. Some blood clots do not exhibit any symptoms. Other risk factors for developing pulmonary embolism include age, immobility, cancer, smoking, birth control pills, pregnancy, and recent surgery.

Noncardiac Chest Pain

Chest pain can also happen for reasons that have nothing to do with your heart. Other organs and body systems sit in or pass through your chest, so discomfort in this area isn’t always caused by your cardiovascular system. Once doctors examine you to make sure there’s no serious heart or lung condition, the next organ to consider is your esophagus, the tube that brings food and drinks you swallow down to your stomach.

In your chest, your esophagus is right next to your heart. Problems with either one actually activate the same nerves, so it can be hard to tell which one is hurting. Acid reflux is often called heartburn because that’s where it hurts in your body. Heartburn is a much more common cause of chest pain than a heart attack, but since it can be hard to tell which one you’re having, it’s important to get medical care.

Issues with your lungs can also sometimes show up as chest pain.

Noncardiac chest pain could be caused by:

• Asthma — A condition where your airways are narrowed and breathing becomes difficult. Chest tightness and pain are very common symptoms.
• Sprained chest muscle — You could get a cramp in your chest muscles or strain or pull a chest muscle while you are working out.
• Pneumonia — This lung infection or other inflammation in your lungs can cause chest pain. If the pain is on both sides of your chest, this could be a sign that it’s coming from your lungs rather than your heart.
• GERD (gastroesophageal reflux disease) — When stomach acid rises into your esophagus, it can burn and cause pain. This can also be called heartburn or acid reflux.
• Ulcers — Sores in your stomach lining can cause pain that feels like it’s in your chest. Gastritis, or an inflamed stomach lining, can do the same.
• Inflammation or muscle spasms in your esophagus — The muscles in your esophagus can constrict and spasm and cause pain that feels like it’s behind your breastbone.
• Gallstones — Although it’s more common to feel pain from gallstones in your abdomen, they can cause chest pain, too.
• Panic attack — A panic attack and anxiety can be common causes for your chest to feel tight or strained. In a panic attack, you can feel suddenly very afraid or panicked, and breathing can become difficult.

What a Heart Attack Feels Like

It’s important to understand what a heart attack feels like, so you know when to get help. If you are living with obesity, it’s especially important not to ignore any symptoms of a heart attack because your heart disease risk is higher than someone without obesity. Get medical attention right away if you experience these signs of a heart attack:‌

• Shortness of breath
• Angina (chest pain) that feels like discomfort, squeezing, or crushing
• Lightheadedness
• Insomnia
• Nausea
• Passing out

Reduce Your Heart Disease Risk

Weight loss can improve your heart health. Even a small amount could help a lot. Scientists have proved that losing just 3 percent to 5 percent of your body weight reduces your heart disease risk. Making healthy lifestyle changes that can help you with weight loss may also directly benefit your heart. For example, a diet high in fiber and low in fat, sugar, and sodium is considered heart healthy and might also help you shed pounds.

Regular physical activity is also beneficial for a healthy weight and decreased risk of heart disease. Even a little activity, like a short walk or some gardening, can help. You don’t have to exercise hard to see benefits.

One MyObesityTeam member said, “What’s worked for me more than any diet or plan is portion control, eating good, nutritious food, and moving around by doing whatever I like to do.”

Find Care That Works for You

No matter what is causing your chest pain, it’s a good idea to have it looked into. If you’d like to reduce your risk of heart disease and improve your life, talk to your doctor about healthy habits, self-care, lifestyle changes, and mental health approaches that might work well for you.

Join the Conversation

On MyObesityTeam, people share their experiences with obesity, get advice, and find support from others who understand.

Have you ever experienced chest pain? How did you get treatment? Let others know in the comments below.