Chest Pain, Noncardiac

What is noncardiac chest pain?

Chest pain is discomfort that is felt anywhere between your neck and belly button. Noncardiac chest pain is pain that is not caused by a heart problem. Because it is very important to determine the cause, always see your healthcare provider if you have chest pain.

How does it occur?

The most worrisome causes of chest pain are related to your heart. However, many causes of chest pain are not related to a heart problem. These include:

• swallowing disorders such as esophageal spasm, caused by the muscles of the lower esophagus squeezing painfully due to acid reflux or stress
• gastrointestinal disorders such as heartburn, which is stomach acid backing up into the esophagus
• lung disease such as bronchitis or pneumonia
• problems affecting the ribs and chest muscles such as muscle strain or inflammation of the rib joints or muscles
• anxiety or panic attacks
• inflammation of the sack around the heart (pericarditis) or of the lining of the lungs (pleuritis/pleurisy).

How is it diagnosed?

Keeping notes about your chest pain will help your healthcare provider make the diagnosis. Write down:

• what the pain feels like, such as stabbing, dull, or burning
• when it happens and how long it lasts
• where it hurts
• what makes it better or worse
• any other symptoms, such as nausea, vomiting, sweating, or trouble breathing.

Your provider will ask about your symptoms and medical history and examine you. You may have the following tests:

• electrocardiogram (ECG)
• exercise stress test
• echocardiogram (ultrasound scan of the heart)
• cardiac angiogram
• blood tests
• X-rays, such as an upper GI exam
• tests of your esophagus.

How is it treated?

After your provider has confirmed that the chest pain is not caused by a heart problem, he or she will recommend treatment for the problem that is causing the pain.

When should I call my healthcare provider?

Tell your provider if your noncardiac chest pain is getting worse while you are using the treatment your provider recommends. You may need a different medicine or change in dosage, a different treatment, or more tests.

If you have new or different chest pain, call your healthcare provider or 911, or go to a hospital emergency room right away if:

• You have chest discomfort (pressure, fullness, squeezing, or pain) that lasts more than 5 minutes or goes away and comes back.
• You have chest discomfort with lightheadedness.
• Your chest pain goes beyond your chest to one or both arms or to your neck or jaw.
• You have chest discomfort and are sweating a lot or having trouble breathing or are sick to your stomach.

If you live in an area where there is no 911 or ambulance service, have someone drive you to the closest emergency room right away. You can also call the closest law enforcement agency (police, sheriff, or highway patrol) to help drive you to the emergency room.