Chest Pain, Noncardiac

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KEY POINTS

• 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.
• 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.
• Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider how long it will take to recover and how to take care of yourself at home.

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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 find the cause, always see your healthcare provider if you have chest pain.

What is the cause?

Many common causes of chest pain are not related to a heart problem. For example, chest pain may be caused by:

• Heartburn or acid reflux of the esophagus (food pipe), which is stomach acid backing up into your esophagus
• Swallowing problems caused by muscles in your lower esophagus that squeeze painfully or don’t allow food to move into your stomach
• Lung disease such as bronchitis or pneumonia
• Sprains, strains, or injuries to your ribs or chest muscles
• Anxiety or panic attacks
• Swelling and irritation of the lining of the lungs (called pleuritis or 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, pressure, or burning
• When it happens and how long it lasts
• Where it hurts
• What makes it better, such as antacids, pain medicines, or changing positions
• What makes it worse, such as eating or drinking certain foods, lying down, or taking a breath
• 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:

• Blood tests
• Barium swallow, which is an X-ray taken of the upper part of your digestive tract after you swallow barium. Barium is a liquid that helps your esophagus and stomach show up well on the X-ray.
• A test to measure pressure in the esophagus
• Endoscopy, which uses a slim, flexible, lighted tube passed through your mouth to look at your esophagus and stomach

If your healthcare provider thinks your symptoms might be from a heart problem, then you may have tests such as:

• An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat. You may have an ECG while you are resting or while you exercise on a treadmill.
• Echocardiogram (ultrasound scan of the heart)
• Angiogram, which is a series of X-rays taken after contrast dye is injected into your blood vessels to look at your heart

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. Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

When should I call my healthcare provider?

Tell your provider if you keep having chest pain or if it gets worse while you are following 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. Call 911 or your local emergency services right away if you have symptoms of a heart attack. The most common symptoms of a heart attack include:

• Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
• Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
• Trouble breathing
• Breaking out in a cold sweat for no known reason

Along with these symptoms, you may also feel very tired, faint, or be sick to your stomach.