What kind of doctor treats non-cardiac chest pain?

The first time a person has non-cardiac chest pain, he or she usually goes to the emergency room, thinking he or she is having a heart attack. The first thing the emergency room doctor will do is make sure the pain is not a heart attack or due to heart disease.

If it truly is non-cardiac chest pain, the emergency room doctor usually refers the patient to a gastroenterologist, a doctor who specializes in digestive system disorders, for more testing and treatment.

Some people who have had several episodes of non-cardiac chest pain go to their primary care physician or a heart doctor (cardiologist) instead of the emergency room. The doctor will follow the same steps to make sure the pain is not heart-related, then refer the person to a gastroenterologist.

How is non-cardiac chest pain treated?

Although non-cardiac chest pain can be a scary event because it feels like heart pain, it usually can be treated successfully once the doctor identifies the cause of the pain. With the right treatment, the symptoms go away for most patients.

Proton-pump inhibitors (PPI) are the most common treatment for non-cardiac chest pain caused by GERD. Several different PPIs are available. Treatment usually begins with a high dose of a PPI. After GERD symptoms lessen, the dose of the PPI is reduced to the lowest amount that control symptoms. Two or more months of drug treatment may be needed to control symptoms.

What treatments are available for non-cardiac chest pain that is not caused by GERD?

The most common and effective treatment for other health problems that cause non-cardiac chest pain is a medicine that blocks the pain signals. Tricyclic antidepressants (TCAs), used in a low dose, are the most commonly used medicines. A low dose of other types of anti-depression medicine can be used if the patient has side effects from the TCAs.

When non-cardiac chest pain is caused by a muscle problem, simple treatments, such as a heating pad, stretching exercises, or over-the-counter pain relievers like ibuprofen, can relieve the pain.

Non-cardiac chest pain can be due to stress, anxiety, or depression. A psychologist can help patients with these problems work through them so they do not cause chest pain. Talk therapy that teaches the patient how to change or eliminate thought patterns that cause stress can reduce the frequency of chest pain episodes.

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