What might cause chest pain that radiates to the shoulder?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Chest pain radiating to the shoulder can be a warning sign of a heart attack or other cardiac issues, but it may also stem from non-cardiac causes such as muscle strain, acid reflux, gallbladder problems, or nerve compression. Because symptoms overlap across many conditions, identifying the true cause quickly is critical.

If you're experiencing chest pain that spreads to your shoulder, don't guess—get clarity. A free, instant, online symptom check can help you understand possible causes based on your specific symptoms and guide you on the right next steps, whether that means seeking emergency care or scheduling a doctor's visit. It takes just a few minutes and could make all the difference in protecting your health.

Reviewed for medical accuracy: 07/15/2026

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Explanation

Chest pain that spreads to the shoulder is most concerning when it signals a heart attack (also known as a myocardial infarction) or angina. Both conditions occur when the heart muscle doesn't receive enough blood and oxygen, resulting in pain. Because the nerves that carry pain signals from the heart connect to the shoulder area, the discomfort often seems to radiate there.

That being said, there are many other causes of chest pain radiating to the shoulder including problems with the muscles and joints in the upper body (musculoskeletal pain), inflammation of the lining around the heart (pericarditis), lung conditions like pneumonia or pulmonary embolism, and even digestive issues such as acid reflux. Anxiety can also trigger symptoms resembling a heart attack.

Because chest pain radiating to the shoulder may indicate serious heart problems, it's essential to seek immediate medical attention for proper diagnosis and treatment. To help understand what might be causing your symptoms, you can check your symptoms with our free AI-powered tool before speaking with a healthcare provider.

(References)

Malik MA, Alam Khan S, Safdar S, Taseer IU. Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI). Pak J Med Sci. 2013 Apr;29(2):565-8. doi: 10.12669/pjms.292.2921. PMID: 24353577; PMCID: PMC3809224.
Hickam DH. Chest Pain or Discomfort. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 9.
Storari L, Barbari V, Brindisino F, Testa M, Filippo M. An unusual presentation of acute myocardial infarction in physiotherapy direct access: findings from a case report. Arch Physiother. 2021 Feb 15;11(1):5. doi: 10.1186/s40945-021-00099-x. PMID: 33583432; PMCID: PMC7883431.

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