Experiencing chest pain with or without a little shortness of breath is reasonably common during pregnancy, along with all the other aches and pains occurring in this period . However, it is necessary to let your doctor know about the problem as it might indicate serious conditions or pregnancy complications.
Is chest pain an early sign of pregnancy?
Chest pain is not counted among the common early symptoms as it can occur anytime during pregnancy due to various causes. However, in some women it can come with the other symptoms like nausea and stomach pain.
Causes of chest pain in pregnancy
Apart from the rising hormone level, which is often to blame for most pregnancy complaints, certain other factors may also lead to the symptom:
- Gas and indigestion: It is quite common for gas to get trapped in the chest area, leading to indigestion and sometimes a dull chest pain during pregnancy. It often gets worse with the beginning of the third trimester (around the 27th week) , but can occur in the first and second trimesters as well.
- Heartburn and acid reflux: Acid reflux is a common pregnancy symptom in which the stomach acids pass through the lower esophageal sphincter (the valve usually preventing food and stomach acids from escaping the stomach) into the chest, often leading to pain and discomfort that might worsen after eating .
- Stress and anxiety: Apart from leading to muscle tension, headache and backache, severe stress is a common causative factor behind chest pain as well .
- Asthma and breathing difficulty: Women with a history of asthma or bronchitis are more likely to experience the symptoms of shortness of breath along with pain or tightness in the chest while pregnant .
- Breast changes: Your breasts start changing and preparing for breastfeeding right from the time of pregnancy, often causing breathlessness and chest pain.
- Pressure from the growing uterus: As the uterus continues to grow, it starts applying pressure on the adjacent areas, including the diaphragm and chest, often leading to pain and discomfort . This type of pain tends to be worse in twin pregnancies as the uterus needs more space to grow.
- Cough and cold: These are one of the most common causes of mild to moderate chest pain  along with a sore throat.
More serious causes
Serious causes for chest pain in pregnant women may include deep vein thrombosis, coronary heart diseases, heart attack and an ectopic pregnancy . Recent studies show that the symptoms of congenital cardiac disorders such as heart murmur are becoming more common among pregnant women . According to experts, the recent advancements in the medical field might be a key factor behind this as it is allowing more women with congenital heart abnormalities to survive and reach childbearing age. Another responsible factor may be that nowadays, most women do not plan on conceiving before reaching late twenties and being over 28-30 years of age heightens the risks of many cardiac complications.
Differential diagnosis for chest pain during pregnancy
Severe chest ache may indicate any of the following conditions :
- Gastroesophageal reflux disease (GERD)
- Coronary ischemia
- Pericarditis (Inflammation of the pericardium)
- Pleurisy or pleuritis (inflammatory disease involving the pleura of the lungs)
- Progesterone induced muscle and ligament laxity
- Pulmonary Embolism
How to relieve chest pain while pregnant
Consult your health care provider regarding the severity and possible treatment options for the pain. Managing the pain with useful lifestyle changes and natural remedies is advisable as most medicines are not recommended for pregnant women.
Tips for pain management
These tips can help keep the pain under control unless you have an underlying condition:
- Sitting and standing straight as a bad posture can prevent your lung from getting enough oxygen 
- Taking lots of rest
- Using a cushion to keep the upper body propped up when lying down
- Sleeping on your left to prevent the growing uterus from putting extra pressure on the major organs and blood vessels 
- Avoiding lying down right after having a meal
- Eating multiple small meals instead of three large ones (helps prevent acid reflux, heartburn, GERD etc)
- Taking your prenatal vitamins and including plenty of vitamin, calcium, iron and magnesium rich foods in your diet
- Practicing stress relieve techniques like yoga 
- Avoiding alcohol, caffeine, greasy, spicy foods and fast foods (as these often flare up gas and heartburn)
Indigestion and heartburn are the most common causes of pain and discomfort in the chest. The following home treatments can help ease the pain by fighting these problems:
- Drinking ginger and chamomile tea once or twice a day
- Slippery elm is another natural remedy considered safe in pregnancy 
- Drinking a glass of warm milk along with a tablespoon honey
- Eating some almonds as their rich calcium content can help with digestion 
- Having a cup of coconut water as it is one of the most effective natural acid neutralizers
- Adding 2 teaspoons of caraway seeds in some boiling water, letting it steep for 10-12 minutes before straining the liquid and drinking it (use sweeteners if preferable) 
- Apple cider vinegar, as it helps to curb the production of stomach acids
Treatment with medication
Chest pain resulting from serious diseases and complications often call for medical treatment . Your doctor can diagnose the problem and prescribe medications for a healthy pregnancy. Apart from the serious causes mentioned above, pleuritic chest pain, severe breathing difficulty or asthma , digestive disorders and cardiovascular diseases may also require medication.
When to worry about chest pain during pregnancy
- Chest pain accompanied by severe breathing difficulty, rapid pulse , fever, dizziness, shortness of breath, sweating , fatigue, persistent vomiting and numbness in your arms
- Stabbing pain in the left side of the chest (might indicate serious cardiac disorders like a heart attack) 
- Pain that radiates from the chest area into your ribs, arms and jaws
- Severe pain in the right side of your chest (might indicate viral infections, gallbladder disorders and liver diseases) 
- Sudden sharp pain in the chest area, along with swelling in one or both legs (might indicate a blood clotting disorder) 
- Sharp pain centered at the middle part of your chest that comes and goes, lasting just a few minutes at a time (might indicate a heart attack) 
- Chest pain that worsens when breathing deeply (might indicate Pericarditis) 
- Burning pain in the upper chest area (often during or after meals) that tends to worsen while bending over (can be just heartburn, but might indicate serious conditions like hiatal hernia) 
- Stabbing pain and palpitations after exercise or running
- Pain with deep breathing, coughing or sneezing (might indicate pleuritis) 
- Pain with movement of shoulders and arms along with the chest wall being tender to tough (might indicate a musculoskeletal problem) 
- Severe chest pain occurring while lying down at night (might indicate coronary heart disorders)
Chest pain ICD-9 and ICD-10 codes
The ICD-9 code for this symptom is 786.5  while its ICD-10 code is R07 .[ref]
- http://apps.who.int/classifications/icd10/browse/2010/en#/R07 [/ref]