What is non-cardiac chest pain?

Non-cardiac chest pain is the term that is used to describe pain in the chest that is not caused by heart disease or a heart attack.

What does non-cardiac chest pain feel like?

Non-cardiac chest pain is often described as feeling like angina, the chest pain caused by heart disease. The patient feels a pressure or squeezing pain behind the breast bone. Some people also report the pain spreads to the neck, left arm, or back. The pain can last for a few minutes or for hours.

Who gets non-cardiac chest pain?

An episode of non-cardiac chest pain has occurred in as many as 25 percent of adults in the United States. No risk factors have been identified that make a person more likely to get non-cardiac chest pain.

What causes non-cardiac chest pain?

In most people, non-cardiac chest is related to a problem with the esophagus, the tube that connects the mouth with the stomach. There are several different esophagus problems that can cause non-cardiac chest pain.

Gastroesophageal reflux disease (GERD) is the most common cause of non-cardiac chest pain. Also called acid reflux, this condition causes 22 to 66 percent of non-cardiac chest pain.

Other, less common esophagus problems that can cause chest pain include:

  • Muscle problems, also called esophageal motility disorders. In people with these problems, abnormal muscle activity in the esophagus prevents food from moving through the esophagus normally. Esophagus muscle problems include uncoordinated muscle contractions (esophageal spasm), high-pressure contractions or squeezing of the esophagus (nutcracker esophagus), and missing contractions caused by nerve loss (achalasia).
  • Visceral or esophageal hypersensitivity. People with this condition have a lot of pain when there is a very small pressure change in the esophagus or a small amount of stomach acid comes up into the esophagus. People with a normal esophagus would not feel anything from the pressure change or the presence of acid. The reason why some people have this extra sensitivity (hypersensitivity) to pressure or acid is not known.

What other problems can cause non-cardiac chest pain?

Some less-common problems that can cause non-cardiac chest pain include:

  • Muscle or bone problems in the chest, chest wall, or spine (back)
  • Lung conditions or diseases, including diseases of the pleura, the tissue that covers the lungs
  • Stomach problems, such as ulcers
  • Stress, anxiety, or depression

Do people with non-cardiac chest pain have other symptoms?

Patients with non-cardiac chest pain also may have heartburn or a bitter taste in the mouth due to stomach fluid “coming up.” In some patients, non-cardiac chest pain occurs after eating. For some patients, non-cardiac chest pain is associated with stress, anxiety, or depression.