Top-Left Chest Pain: During Exercise and When Lying Down
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Pain in the Top-Left Chest During Exercise and When Lying Down

Pain in the Top-Left Chest During Exercise and When Lying Down
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Updated on August 6, 2025
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Left-sided chest pain can point to various underlying issues, and although it’s where your heart sits, they don’t all involve the heart. Chest pain in this area could also indicate a problem with the lungs, muscles, bones, or digestive system.

There are certain medical conditions in which chest pain can worsen in various positions or while performing specific motions. This can apply to lying down (for example, in people with inflammation of the heart’s outer layer, known as pericarditis) or during exercise (in the case of coronary artery disease, sprained chest muscles, or broken ribs).

 Left-sided chest pain can have serious implications, such as a heart attack, so speak to a doctor immediately if you experience it for longer than five minutes.

Pain in the Top-Left Chest During Exercise

Chest pain during exercise can occur in individuals with certain medical conditions. For example, coronary artery disease (CAD) triggers chest pain called angina that worsens during exercise but improves with rest.

Angina is one of the most common heart problems that causes chest pain. It can have similar symptoms to a heart attack, but it is not life-threatening.

CAD occurs when hardened cholesterol clogs the arteries that supply blood to the heart, causing it to struggle to meet the extra demand needed for exercise as the heart beats harder.

However, chest pain is more common in people who are very active, such as athletes, than in those who don’t move much, according to the Cleveland Clinic. And the causes don’t always involve the heart.

 Other causes of chest pain during exercise include:
  • Bruised or fractured ribs received during chest injuries while playing contact sports
  • Muscle and joint strains in the chest wall, which may occur during a particularly vigorous workout

  • Costochondritis, or inflammation of the cartilage connecting the ribs and breastbone, which occurs most often in rowers, tennis players, competitive weight lifters, and other athletes
  • Muscle spasms, also known as “stitches,” that can occur with overexertion
  • Gastroesophageal reflux disease (GERD), which can exhibit symptoms during abdominal muscle activation that forces the stomach contents back into the esophagus and can cause chest pain
  • Exercise-induced bronchospasm, a condition that can cause intense chest pain and breathing difficulties during or shortly after exercise
  • A blood clot from elsewhere in the body that gets stuck in the lungs, known as a pulmonary embolism, which can cause upper-left chest pain while breathing in

Top-Left Chest Pain While Lying Down

Lying down may also trigger pain in the upper-left chest for those with certain medical conditions.

For example, pericarditis is inflammation of the tissue around the heart muscle, known as the pericardium. It can cause pain in the left side or middle of the chest, and you might also feel it in both shoulders. You might also notice that the pain gets worse when you lie down and breathe deeply, but that sitting upright and leaning forward makes it feel better.

Often, fever accompanies this condition, and you may also experience breathlessness, coughing, heart palpitations, and weakness. If you have chronic or long-term pericarditis, you may experience tiredness, breathlessness, and coughing, but you might not always get chest pain.

It’s not only cardiac conditions that can cause chest pain while lying down. If you have GERD and experience its symptoms in your chest, it’s known as heartburn. It may feel worse when you’re lying down soon after a meal or in bed at night.

When to See a Doctor

Most chest pain doesn’t indicate a serious health issue, but it’s important that you have a healthcare professional rule out anything life-threatening. Sometimes, pain in your upper left chest that occurs during exercise or when lying down may indicate serious heart problems or other potentially life-threatening conditions.

You need to seek immediate medical attention if you experience the following:

  • Sudden, crushing, squeezing, and tightening pressure in your chest
  • Pain that radiates to your jaw, left arm, or shoulder blades
  • Chest pain accompanied by a shortness of breath, nausea, dizziness, sweating, and a rapid heartbeat
  • Chest pain that gets worse, only occurs after easy exertion, or lasts longer than usual
  • Chest pain that occurs at rest, especially after long trips, extended bed rest, or other periods of reduced movement, especially if a leg is swollen, as this could suggest a blood clot
  • Chest pain that occurs when you’ve already have a diagnosis of a condition such as a heart attack or a pulmonary embolism

Contact a healthcare provider if the following apply:

  • The chest pain occurs along with a fever or cough that produces green or yellow phlegm.
  • The chest pain is severe and doesn’t get better.
  • You find it hard to swallow.
  • The chest pain has lasted longer than three to five days.

The Takeaway

  • Pain in the upper-left chest during exercise can have links to serious conditions like coronary artery disease, and you shouldn’t ignore it. However, most chest pain isn’t a sign of a severe health issue.
  • Noncardiac causes, such as muscle strains, stress injuries in athletes, and GERD, can also lead to chest pain during specific activities.
  • Chest pain while lying down might result from pericarditis or aggravated symptoms of GERD, which requires careful evaluation by a medical professional.
  • While not all chest pain comes from the heart, unexplained pain in this area that occurs frequently or is severe should prompt an immediate visit to a healthcare provider.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Left-Side Chest Pain. Cleveland Clinic. July 6, 2023.
  2. Chest Pain in Young Athletes: When You Should Be Concerned. Cleveland Clinic. October 18, 2021.
  3. Chest Pain. National Health Service. August 8, 2023.
  4. Coronary Artery Disease. Mayo Clinic. June 14, 2024.
  5. When Chest Pain Isn’t a Heart Attack. University of Michigan Medicine. February 16, 2023.
  6. Symptoms and Diagnosis of Pericarditis. American Heart Association. June 6, 2024.
  7. Acid Reflux and GERD. Cleveland Clinic. September 28, 2023.
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Scott Haak, PT, DPT, MTC, CSCS

Medical Reviewer

Scott Haak, PT, DPT, has been a member of the Mayo Clinic staff since 2000. Dr. Haak serves as faculty for the Sports Medicine Fellowship program at Mayo Clinic Florida. He is certified by the NSCA (National Strength and Conditioning Association) as a CSCS (Certified Strength and Conditioning Specialist), is a Certified USA Weightlifting Coach and Certified USA Football Coach, and possesses a MTC (Manual Therapy Certification) from the University of St. Augustine for Health Sciences.

Haak is an exercise enthusiast and enjoys running, weightlifting, and sports performance training. He is the president and director of coaching of a youth tackle football organization, JDL Providence Football, and currently coaches high school football and weight lifting.

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Jan Millehan

Author

Jan Millehan has published articles relating to health, fitness and disease on various websites. Her publishing history includes health-related articles on blogs and online directories, as well as an essay published in the Bridgewater College journal, "Philomathean." Millehan received a Bachelor of Science in elementary education from Bridgewater College.

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