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Can Caffeine Cause Chest Pains?

by
author image Doug Dohrman
Doug Dohrman earned a Ph.D. in neuroscience from the University of Iowa. Following post-doctoral training at UCSF, he directed courses in neuroscience and histology for first year medical students and has also taught in anatomy, physiology and biostatistics. His research background is in cell and molecular biology and he is currently involved with medical editing/writing.

If you are like most adults, drinking coffee, tea or other caffeinated beverages is part of your daily routine. Most people like the fact that coffee or tea helps wake them up. The stimulant effects of caffeine, when consumed in moderation, can have other desirable effects, such as improved mental alertness and concentration. On the other hand, too much caffeine can cause unwanted side effects. While chest pain is an unlikely one, excessive coffee or caffeine can make you feel restless, anxious, jittery or have headaches.

Caffeine Sources

The daily diets of 89 percent of U.S. adults contain caffeine, according to a study published in the May 2015 issue of “American Society for Nutrition,” and 70 percent of this caffeine comes from coffee. Many other products contain caffeine, including soft drinks, energy drinks, tea, chocolate and some pain medications, including Excedrin and Midol. An 8-ounce cup of coffee can contain anywhere from 95 to 200 mg of caffeine, yet coffee is often served in 12- to 16-ounce servings, providing up to 300 mg per serving. Tea and sodas typically contain less than 50 mg of caffeine per 12 ounces. The U.S. Food and Drug Administration has determined that less than 400 mg of daily caffeine in adult diets is considered moderate intake and is not associated with dangerous or unhealthy effects. However, caffeine intake is discouraged in adolescents and children.

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Caffeine Cardiovascular Effects

Caffeine can act as a vasoconstrictor, a substance that narrows blood vessels, so it has been suspected to contribute to chest pain, blood pressure or heart disease. But the cardiovascular impact of caffeine is not so simple. Right after consuming caffeine, a mild and temporary constriction of blood flow can occur -- which could lead to a short-lived increase in blood pressure or heart rate. However, this effect is more pronounced in people who do not regularly consume caffeinated beverages. Caffeine primarily acts as a vasodilator, which means it improves blood flow. A 2013 review in the “Journal of the American College of Cardiology” summarized that moderate consumption of caffeine is not linked to heart disease or stroke risk, and it appears to be associated with several positive health benefits, including a reduced risk of death from all causes.

Caffeine and Chest Pain

Excessive caffeine consumption, or even average caffeine intake in sensitive individuals, is linked to a variety of side effects -- fast heartbeat, anxiety, insomnia, shakiness -- and it’s possible some of these symptoms, if severe, could be construed as chest pain. People with acid reflux, or heartburn symptoms, may find that coffee or chocolate triggers their symptoms, some of which may be similar to chest pain. So it’s possible some sensitive individuals may experience chest pain with excess caffeine intake. Also, the literature includes some case reports of severe chest pain that were potentially related to caffeine. For example, a 19-year-old man with a 2-year history of drinking 2 to 3 caffeine-containing energy drinks each day experienced chest pain and a heart attack, according to a June 2011 article in “BMJ Case Reports.” While his consistent and high intake of caffeine was the suspected culprit, this energy drink also provided high doses of the amino acid taurine, and it's unknown if the taurine or its interaction with caffeine was also related.

Warnings

Moderate caffeine intake is considered safe for most people. If you have trouble sleeping or are under your doctor’s care for any medical conditions, discuss planned caffeine use with your doctor. Because caffeine-containing pills can provide excessive and unsafe amounts of caffeine, only take these under a doctor’s supervision. Chest pain has a variety of causes -- some severe and life-threatening, so any chest pain needs to be evaluated by your doctor. If caffeine is the suspected culprit, cutting back or avoiding this substance is worth a try. Seek emergency medical attention if you have chest pain, chest tightness and a sudden crushing chest pain that radiates into the neck or arm. Also get medical attention if your chest pain is accompanied by jaw or back pain, sweating, shortness of breath or dizziness.

Reviewed by: Kay Peck, MPH RD

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