Back pain as a symptom of Heart Attack

Heart Attack Symptoms.. A Medika Life Series on Heart Health

This article is part of Medika’s series on heart health and seeks to educate patients about the symptoms of heart disease and how these symptoms present.

What does heart related back pain feel like?

This symptom, usually occurs in your upper back and is more likely to affect women. The pain can originate in your chest and then “move” to your back. Although most often felt in the upper back, it can also occasionally cause pain in the lower back.

Onset can be sudden and pain can wake you at night. The pain is most often described as originating between the shoulder blades. As there are many non-heart related causes for back pain, its important to consider any of the other heart attack symptoms that would indicate your pain is heart related. If you find it difficult to pinpoint the pain, this could be an indicator of heart related pain.

Why does your heart cause this symptom?

It’s a case of crossed wires. Our bodies are normally very specific when they send out pain signals. Close your finger in the door and you know which part of your body isn’t impressed with you. The heart is a little bit more complicated as it shares nerves that send out signals to our arms, head and upper body.

As a result heart related symptoms like back pain are called referred pain. In other words, although that area feels painful, it isn’t the problem. Your heart is the issue and the signals have simply gotten mixed up. The source of origin for referred pain is also more diffuse and difficult for patients to pinpoint.

Accompanying symptoms

Back pain can occur as an isolated symptom or be accompanied by pain in your neck, jaw, shoulder or chest and you may experience nausea, sweating, shortness of breath, dizziness, or lightheadedness. If your back pain is accompanied by any these symptoms, seek immediate medical help.

If you’ve recently noticed any of the following, you should also seek medical attention if your back pain is unexplained.

  • feeling tired or out of breath from your normal day to day routine
  • struggling for breath from activities that don’t normally tax you
  • feeling tired and listless but struggling to sleep
  • sudden feelings of dread or anxiousness (panic attack)

Gender prevalence for back pain

Women experience this symptom far more than men do and many women report the pain as having started in their chests and then moving to the upper back area. For women, it is a typical red flag, but men may not experience any back pain at all. Women are also more likely than men to feel their back pain while they’re resting or sleeping.

Alternate Causes of back pain

Even if you suffer from any of the conditions listed below, you may still experience back pain as a result of a heart condition. The pain may not feel the same as the pain you normally experience from an existing condition.

The most common causes of upper back pain are muscular, related to poor posture, trapped nerves or degenerative conditions of the spine and bones. These include some of the following

  • Back muscle spasm, sprain or strain
  • Cancers
  • Degenerative disc disease
  • Herniated (bulged or ruptured) disc
  • Lung Cancer
  • Osteoarthritis
  • Osteomyelitis
  • Osteoporosis
  • Spinal stenosis
  • Spondylitis

A life-threatening cause of back pain is an aortic dissection, a condition in which the biggest artery in your chest tears.

Are there clear signs it’s your heart?

There are a few tell tale signs that would indicate the pain in your back is related to your heart.

  • Sharp pain that wakes you but you are unable to pinpoint the source of the pain
  • Pain is most often described as occurring between the shoulder blades
  • If the pain is accompanied by sudden excessive sweating not related to menopause
  • If you find yourself suddenly short of breath from normal activities
  • If your back pain is accompanied by one or more of the other heart related symptoms seek immediate medical attention

When to call your Doctor or 911

If you are experiencing upper back pain, especially pain that travels to your jaw, neck or down your arm, and are having associated symptoms of nausea, dizziness, sweating, or shortness of breath, call 911 right away.

If you are in an at risk group for heart disease (elderly, diabetic, obese, overweight, smoker or high blood pressure) then you should treat any back pain seriously. The more prolonged the discomfort or pain is, the faster you should seek medical care. Dial 911 or visit your nearest ER


Medika Life has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life

Dr. Hesham A. Hassaballa
Dr. Hesham A. Hassaballa
Dr. Hesham A. Hassaballa is a NY Times featured Pulmonary and Critical Care Medicine specialist in clinical practice for over 20 years. He is Board Certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine, and Sleep Medicine. He is a prolific writer, with dozens of peer-reviewed scientific articles and medical blog posts. He is a Physician Leader and published author. His latest book is "Code Blue," a medical thriller.
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