Non-cardiac chest pain still dangerous

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Chest pain is often thought to stem from cardiovascular disease. However, there are many other causes, ranging from digestive issues to stress and anxiety. Any chest pain should be taken seriously and emergency medical attention should be sought as soon as it appears.

According to information updated in April 2022 by the Cleveland Clinic, 25% of adults in the United States report chest pain that is not related to heart problems. Fifty to 75% of ER admissions for chest pain are attributable to non-cardiovascular diagnoses and are referred to as non-cardiac chest pain (NCCP). However, all chest pain should be treated seriously.


Physical sources of chest pain

Sources of non-cardiac chest pain can be from the esophagus, muscle problems, lung problems, and gastronomic difficulties. The American College of Gastroenterology (AGC) reports that NCCP can occur at any age and affects approximately 70 million adults in the United States. The American Academy of Family Physicians (AAFP) states that it occurs about as often in men as in women, but some statistics from other sources show a slight increase in cases in women.

The most common reports of NCCP come from problems with the esophagus, the tube that carries food from the mouth to the stomach and is located near the heart. Among the esophageal problems that can cause pain is chronic acid reflux, officially known as gastroesophageal reflux disease (GERD). According to the Cleveland Clinic, GERD is the cause of 50-60% of NCCPs. The esophagus can also become inflamed from food allergies or other reasons that can cause chest pain. Other causes of esophageal chest pain that occur more rarely are achalasia, a condition that causes regurgitation of food, esophageal spasms, and the presence of abnormal esophageal tissue.

Beyond esophageal problems, other causes of NCCP can include lung disorders, including problems with the tissues surrounding the lungs. A pulmonary embolism (PE), which is a blood clot in the lungs, can cause chest pain. Pleurisy, an inflammation of the tissues around the lungs, can also lead to chest pain, especially when coughing or simply inhaling. Pulmonary hypertension, or increased blood pressure in the arteries carrying blood to the lungs, can lead to chest pain.

Additionally, problems involving the bones and muscles around the chest wall and back can create NCCP. An inflammation of the cartilage around the ribs called costochondritis is another source of chest pain. This is especially apparent when the cartilage that connects the ribs and breastbone becomes inflamed. Sore rib muscles, injured ribs, and certain chronic conditions such as fibromyalgia can also cause chest pain.

Among the illnesses associated with NCCP is shingles, a reaction to the varicella virus. Ulcers and gallbladder problems can also cause chest pain. Problems with the pancreas and the presence of tumors can also lead to chest pain.

Non-Physical Reasons and Symptoms of Chest Pain

Stress, depression, anxiety and panic attacks have all been associated with NCCP. There are similar symptoms, especially with panic attacks and heart attacks. Among them are shortness of breath, dizziness, a tingling sensation and intense sweating. Fainting and a sense of impending doom can also occur in both conditions. Additionally, Cedars-Sinai Medical Networks suggests that any previous experience of a panic attack or heart-related chest pain can provide insight into diagnosis and treatment.

Certain sensations often appear with NCCP, according to the Mayo Clinic. They include difficulty swallowing, pain that occurs with deep breathing or coughing, and pain that may increase or decrease when body position changes. Also, foods with a sudden and unusual sour taste may accompany non-cardiac chest pain.

Treatment options

Once the physical causes of chest pain are diagnosed, treating them often relieves chest pain and other symptoms. The AAFP states that because some causes of NCCP are not physical, cognitive-behavioral therapy and other methods have been proven successful in these diagnoses. Consultation with primary care and other physicians will help determine the best way to treat the problems causing NCCP.

Treat all chest pain seriously

It is recommended by the Cleveland Clinic that if the chest pain is new, sudden, and lasts longer than five minutes, the sufferer should go to the emergency room immediately.

To learn more about a variety of health conditions, management, and treatment, log on to vascularhealthclinics.org.

Do you have questions about your heart health? Ask Dr. Haqqani.

If you have questions about your cardiovascular health, including heart, blood pressure, stroke lifestyle and other issues, we want to answer them. Please submit your questions to Dr. Haqqani via email at [email protected]

Omar P. Haqqani is the Chief of Vascular and Endovascular Surgery at Midland Vascular Health Clinics.

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