Chest pain is one of the top reasons for emergency department visits. However, 7 out of 10 patients who presented with chest pain with a scare of heart-related issues get discharged without a clear diagnosis or diagnosed with non-cardiac chest pain.
Non-cardiac chest pain is characterized by chest pain near the heart behind the chest bone but is not related to heart disease. Although it is reassuring to patients that their chest pain is not originating from the heart, the frequent chest pains of unknown cause could be frustrating.
Our chest cavity has major organs, including the heart, food pipe or oesophagus, lungs, ribs, sternum or chest bone, and intercostal muscles. An expert gastroenterologist explains that chest pain can originate from any of these parts. He also explains easy ways to identify the cause of chest pain and when to seek urgent medical care.
Site of pain
If the pain is coming from the chest’s centre or left side of the chest, and the pain intensity seems to be increasing and lasting for over a few minutes, then you should seek immediate medical care, as it might be coming from your heart.
Nature of the pain
You may experience pain in the centre of the chest, even if there is an issue with your food pipe. But what differentiates it from heart-related pain is the nature of the pain. If you are experiencing heaviness or pressure in the chest that grows and extends to the left arm, neck, jaw, and back, the pain might be heart-related, and you should seek emergency care.
However, if you are experiencing burning pain in the centre of the chest, which gets relieved by burping, drinking water, milk or antacids, it might be originating from the food pipe. If you experience pain while taking deep breaths or coughing, it might indicate irritation in the layers covering the lungs due to infections.
If you are experiencing sharp bouts of pain like pricks lasting for only seconds, it might not be originating from the heart. If you feel tenderness or soreness in specific, precise locations in the chest, it could be due to inflammation or swelling in the musculoskeletal system of the chest.
Position or activity
If the pain is experienced in certain positions or while bending down or lifting and moving the arms, it could be a muscular pain unrelated to the heart. Moreover, pain coming from the heart cannot be reproduced by changing positions.
In contrast, if you are experiencing chest pain while walking or climbing a hill or stairs and it settles down when you take a rest, it could be due to a heart condition called angina. You should seek medical care as there could be a shortage of blood supply to the heart.
Stress
People who are highly stressed or those who get panic or anxiety attacks may experience tightness in the chest due to spasms in the chest muscles. These muscle pains can also be mistaken for chest pain due to heart problems.
The connection between chest pain and gastroenterological issues
Non-cardiac chest pain is caused primarily due to problems in the food pipe or oesophagus, including:
- GERD – Gastroesophageal reflux disease, commonly called acidity, is caused due to reflux or back-tracking of the stomach's digestive acids into the food pipe. It occurs due to malfunctioning of the valve that guards the opening of the stomach and prevents the reflux of stomach contents into the food pipe. As the inner lining of the oesophagus is very sensitive to acids, it causes a burning sensation in the chest. It is often mistaken for chest pain coming from the heart. It usually gets relieved after taking water, milk or antacids.
- Spasms – Some people experience muscle spasms or abnormal twisting in the oesophagus muscles. These spasms cause severe chest pain that mimics pain coming from the heart.
- Trapped air – We swallow air while eating or talking, and this air sometimes gets trapped in the food pipe. It causes chest discomfort, which may go away with burping.
- Hypersensitive oesophagus – Some people have a highly sensitive food pipe, which causes discomfort in the chest even with small amounts of acid reflux or movement of food.
Takeaway points
- Non-cardiac chest pain is pain in the chest which is not caused due to heart-related problems. Issues in the food pipe or oesophagus, including GERD or acidity, abnormal spasms in the food pipe, gas trapped in the food pipe, and hypersensitive food pipe, could be common causes of non-cardiac chest pain.
- The nature of the pain –a burning sensation that goes away with taking water or antacids or heaviness in the chest– can help differentiate the pain originating from the food pipe or heart.
- People experiencing chest pain without any heart ailments should visit a gastroenterologist to get their food pipe evaluated and get an appropriate diagnosis and treatment.
If you are looking for a digestive health specialist or the best gastroenterologist in Bangalore to diagnose and treat your non-cardiac chest pain, visit Bangalore Gastro Centre Hospitals at HSR Layout in Bangalore. The hospital team includes the best gastro doctors who can identify the root cause of your non-cardiac chest pain.
