Atypical Chest Pain

What is atypical chest pain?

Atypical chest pain is chest pain that doesn’t fit the description of typical or classic chest pain.

Typical or classic chest pain generally has all three of the following features:

• It feels like pressure or heaviness under your breastbone.
• It’s worse when you exert yourself.
• It lasts for at least two minutes and goes away when you rest or take nitroglycerin.

Noncardiac chest pain has one or none of these characteristics.

Atypical chest pain is a type of chest pain that only has some of the features of typical chest pain. It may also include chest pain that:

• Lasts for a few seconds, then quickly subsides.
• Worsens when your body is in certain positions.
• Feels like a sharp or stabbing pain.

Atypical chest pain is the top symptom of people who visit the emergency department or their primary healthcare provider. For 66% of them, their heart isn’t the cause of their pain.

Typical vs. atypical chest pain

Typical chest pain

• Pain feels like squeezing, tightness, crushing or pressure.
• Happens with exertion and feels better with rest.
• Sweating, upset stomach or shortness of breath may go with it.
• Pain spreads to your arms, neck or jaw.
• Pain may increase when you exert yourself.
• Pain usually lasts at least two minutes.

Atypical chest pain

• Feels like a sharp or stabbing pain.
• May be positional in nature (gets worse in certain positions).
• May not be related to exercise or feel better with rest.
• Pain may stay at one level.
• Pain lasts seconds, then quickly subsides.

What are the risk factors for atypical chest pain?

Risk factors for atypical chest pain include:

• Being female or assigned female at birth (AFAB).
• Having high blood pressure.
• Having kidney disease.
• Having diabetes.
• Having a history of a heart attack.

What are the most common causes of atypical chest pain?

Atypical chest pain causes can range from heart or lung conditions to issues with your esophagus or an anxiety disorder.

Atypical chest pain causes, which may or may not be heart-related, include:

• Acute coronary syndrome.
• Pericarditis.
• Myocarditis.
• Broken heart syndrome.
• Costochondritis.
• Aortic dissection.
• Aortic aneurysm.
• Aortic valve stenosis.
• Pulmonary embolism (PE).
• Lung cancer.
• Pneumonia.
• Pneumothorax (collapsed lung).
• Chronic acid reflux.
• Esophageal spasm.
• Esophageal rupture.
• Esophagitis.
• Anxiety.
• Broken rib.

How is atypical chest pain treated?

Treatment varies greatly depending on the cause of your atypical chest pain. Treatments range from various medications to procedures to operations.

To find the cause of atypical chest pain, healthcare providers will order tests, such as:

• Electrocardiogram (EKG).
• Computed tomography (CT) scan.
• CT coronary angiogram.
• Positron emission tomography (PET) scan.
• Heart MRI (magnetic resonance imaging).
• Echocardiogram (Echo).
• Chest X-ray.
• Cardiac catheterization.
• Stress test.

What can I do at home to treat atypical chest pain?

There isn’t any home treatment for atypical chest pain. A healthcare provider will need to evaluate you and diagnose you to give you the appropriate treatment. Depending on the cause, you may have an urgent need for treatment.

What are the possible complications or risks of not treating atypical chest pain?

Some of the causes of atypical chest pain are life-threatening. This is especially true for conditions that affect your heart and lungs.

Can atypical chest pain be prevented?

You may be able to prevent some causes of atypical chest pain by living a healthy lifestyle. That includes:

• Not using tobacco products.
• Eating heart-healthy foods.
• Exercising regularly.
• Getting the vaccines your provider recommends for you.
• Treating medical conditions you already have.

When should this symptom be treated by a doctor or healthcare provider?

You should always contact a healthcare provider about atypical chest pain. They can tell you what’s causing it and give you the care you need. Some of the causes are life-threatening issues that need immediate care, so be sure to contact your provider right away.

A note from Cleveland Clinic

Many different medical conditions can cause atypical chest pain. That’s why you owe it to yourself to contact a healthcare provider when you have this symptom. A provider can determine the cause and give you the right treatment.

If you have atypical chest pain, your symptoms may not be as obvious as with typical chest pain. You may need to be assertive about getting the treatment you need. Don’t be afraid to be your own advocate to get the proper care.