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Neck, chest, and shoulder are innervated by branches of the same nerve. This means that problem in one of these areas may cause pain in other two areas. Typical causes of pain are injuries to muscles and ligaments, but pain can be triggered by problems with spinal cord, lungs, heart and other abdominal organs as well. Some less obvious causes for painful neck, shoulder and chest are, in example, heart attacks, excessive coughing and gallbladder disease. More obvious causes of pain would include broken shoulder blade, broken collar bone, stretching of the ligament that connects collar bone and shoulder blade, (sports) injury to group of shoulder muscles known as rotator cuff, and others.

Conditions that cause pain in neck, shoulder and chest

Heart conditions responsible for pain in discussed region include heart attacks (caused by blocked arterial supply of blood in a part of the heart muscle), angina (chest pain caused by partial blocking or narrowing of arteries in the heart which causes lack of oxygen in heart muscle cells), tearing in the lining of the aorta (main artery, a highway for supplying oxygen-rich blood to the entire body) which causes sharp, intense pain in the upper back and chest.

Acute inflammation of the pericardium (sack which covers the heart) causes sharp pain that can be relieved by leaning over while seated. Irritation of the diaphragm caused by inflammation of the pericardium can cause shoulder pain. Prolapse of one of the valves (mitral valve) in the heart causes backflow of blood into the heart and causes fleeting chest pain. Also known as mitral valve prolapse, this condition can also cause shoulder pain in patients with fibromyalgia, which it often follows.

Esophageal disorders can result in pain that is alarming, as it is very similar to pain caused by heart attack. One of the most common esophageal disorders is gastroesophageal reflux disease, also known as GERD or heartburn. It is characterized by backward flow of intestinal juices from stomach into the esophagus. As these contain hydrochloric acid that burns esophageal lining, what seems to be chest pain is the result. Inflammation or spasm of the esophagus also causes chest pain.

Chest pain can be caused by a blood clot stuck in the lungs, entrance of air within chest wall and lungs which causes inability of the lung to expand, pneumonia and other conditions.

Tear or hole anywhere in the gastrointestinal tract allows air to enter the abdominal cavity and irritate diaphragm. This can cause chest and shoulder pain.

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