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So back to your question: 1  Your chest hurts when you're emotionally sad because your brain processes physical and social pain in the same brain regions (dACC and AI) (the affective aspects of the pain). The fact that both pains overlap means the factors that decrease physical pain also decrease emotional pain.
Chest pain is also caused by irritation and swelling of the heart (myocarditis) or its outer covering (pericarditis). This inflammation can be caused by an infection or happen after heart attack or heart surgery. Pain from myocarditis or pericarditis is usually is sharp and in the center of the chest. It tends to get worse when you breathe, lie down, cough or swallow. Sitting or leaning forward sometimes reduces the pain.