When you’ve just started a running habit—or perhaps you’re a seasoned runner—feeling your heart hurt can be a scary experience. Fortunately, most causes of chest pain while running are benign, but it’s possible that it could be serious or at least something that needs to be looked at by a doctor.
Non-Heart-Related Causes of Chest Pain While Running
While chest pain and chest pressure are symptoms of sudden cardiac arrest and heart attacks, not all chest pain is related to cardiovascular disease. In most cases, feeling your heart hurt when running is attributable to musculoskeletal strain or indigestion.
New to Running
New runners asking “why does my heart hurt when I run” will often find that the chest pains they feel are simply a consequence of using muscles they haven’t used much before. Heavy respiration works the heart, lungs, and chest muscles harder than they’re used to working and the result is a feeling of heart pain. If you feel a sharp pain, you may have even strained the intercostal muscles (the muscles surrounding your rib cage).
To prevent sore chest muscles, make sure you warm up with a brisk walk and run at a steady pace rather than in short bursts. On cold days, keep your muscles warm with long jogging clothes, and always remember to stretch afterward (including your chest). In both cold and hot weather, drink plenty of electrolytes to prevent chest cramps from dehydration. However, avoid a big meal, as this could lead to chest pain from heartburn.
Vocal Cord Dysfunction
Healthy vocal cords open when you breathe and close when you lift something heavy, speak, and swallow. However, when you’re running, it’s possible for the vocal cords to remain closed when you most need them to open and let air through, and this constriction of the airway can cause you to feel chest pain. If you are struggling with closed vocal cords while running, the best solution is usually respiratory retraining therapy.
The ribs, lungs, and heart are all close together in the chest, which is why a problem with the rib muscles or lungs could feel like your heart hurting. Some exercise-induced lung problems can become dangerous, so you should see your doctor if you suspect a lung-related cause.
Coughing, wheezing, and shortness of breath while running could be signs of exercise-induced asthma. If you don’t normally have asthma but experience these symptoms when running, your doctor might prescribe a pre-exercise medication and give you an inhaler to use if you become short of breath on a run. If these symptoms progress and you’re struggling to breathe, call 9-1-1 immediately.
Other Lung Problems
There are a few other lung-related causes of chest pain while running.
- Exercise-induced bronchospasms (EIB) are spasms in the lungs’ small airways that might happen in certain environments or seasons.
- Pleurisy is an inflammation of the tissues that line the lungs and chest. Symptoms include chest pain, trouble breathing, and a persistent cough.
- Recent COVID-19 or pneumonia puts runners at an increased risk of lung problems, including pleurisy. Before restarting your exercise routine after illness, see a doctor to get medical clearance and ease into running slowly.
- Pneumothorax happens when air leaks into the space between the chest wall and the lungs.
- A pulmonary embolism occurs when there is a blood clot in one of the arteries to the lungs. Both conditions cause severe pain and shortness of breath, even after resting, and are serious. Seek medical attention right away if you experience these symptoms.
In Rare Cases, Chest Pain When Running Is a Sign of Heart Disease or a Cardiac Event
Experiencing sudden cardiac arrest while running is uncommon—only 0.54 out of 100,000 runners experienced SCA in 40 marathons and half-marathons. However, as you don’t know whether you’re one of the 0.54 or one of the 99,999.46, it’s important to be aware of the possible heart-related causes and symptoms so you can be evaluated and treated, if necessary. If you are at a higher risk for cardiac events, it’s a good idea to run with a friend and take an easy-to-use automated external defibrillator with you in a backpack, such as the LIFEPAK CR2 or Philips HeartStart FRx.
Angina occurs when a person’s coronary arteries, which transport blood to the heart, contract or become smaller. The resulting insufficient blood supply can cause chest pain when running. If you have angina, your heart should stop hurting after resting for a few minutes. However, it’s still important to see a doctor for follow-up tests and treatment.
If you have heart disease or a risk factor like smoking, experiencing chest pain while running could indicate a heart attack. Common symptoms of a heart attack include:
- Worsening chest pain
- Pain in the upper body, left arm, jaw, or back
- Heavy sweating
- Nausea or vomiting
- Shortness of breath
If these symptoms come on with intense physical activity but go away when you rest, the pain could be a sign of a heart attack. Call 9-1-1 immediately if you experience these symptoms when running.
Supraventricular tachycardia (SVT) is an arrhythmia from the heart’s top chambers that makes you feel as though your heart is racing. It can also induce chest pain, palpitations, and shortness of breath.
While SVT is not typically life-threatening, it’s still important to call your doctor or seek medical attention if your heart goes above 150 beats per minute and stays elevated, as you may need to learn and apply the Valsalva maneuver or take medications to slow your heart rate down.
Hypertrophic cardiomyopathy is a thickening of the heart muscle—usually the left ventricle. This thickening blocks a certain amount of blood flow from the heart, which can lead to chest pain, palpitations, and shortness of breath when you exercise. People with HCM don’t necessarily suffer a heart attack, but HCM is a risk factor for sudden cardiac arrest. Treatments for HCM often involve medications that relax the heart muscle.
What You Should Do If Your Heart Hurts While Running
If you’re new to running and experience slight chest discomfort that goes away when you rest, drink some water or electrolyte solution and wait for the feeling to pass. It’s also a good idea to keep any pre-run snacks light, warm up before heading off, and stretch your chest after you’re done to reduce the likelihood of chest pain.
However, if you experience sharp chest pain while running and also have nausea, dizziness, pain in the back, jaw, or left arm, palpitations, or profuse sweating (it might be hard to tell it apart from regular sweat), call 9-1-1 immediately as it might be a medical emergency.
If in doubt, it’s always better to get checked out and find that nothing is wrong than to ignore a pain in the heart region and have it turn out to be something serious. And if you can, run with a buddy who is trained in CPR and know the location of the nearest AEDs on your route (or take one with you). You never know when either you or your running buddy might experience a cardiac event and need a helping hand.