Chest pain can be one of the scariest symptoms a patient may experience. Almost everyone recognizes chest pain as being potentially due to coronary heart disease. Of course, it will be important to rule out any life threating cause as soon as possible.  A cardiac evaluation, looking for evidence of a heart attack, along with x-ray studies to rule out things like pulmonary emboli and lung collapse, called a pneumothorax, should be done.

However, if all of the above studies fail to reveal the cause of the chest pain, patients still want to know the source of their discomfort.  Patients with COPD should know that there are many other causes for their chest pain.  Gastroesophageal reflux, or GERD, is a frequent cause of chest discomfort and is a commonly associated problem with COPD.  The constant inflammatory environment seen in COPD can result in scarring and adhesions between the surface of the lung and the inner surface of the chest, so-called pleural adhesions. There are a number of neural networks connected to the diaphragm and other inner chest areas that are also influenced by the chronic inflammation of COPD.  Lastly, the muscles, ribs and cartilage of the chest wall can become stressed by the changes associated with the hyperinflation in COPD.  These anatomic changes can result in a variety of chest pain symptoms.

To be clear, if you are having chest pain be sure to look for emergent problems first, but COPD patients have many other causes for pain.