What Could Be The Cause Of Chest Pain – Noncardiac chest pain is chronic chest pain that feels like it’s in the heart, even though it’s not. It is usually located in the esophagus, which is right next to the heart. If you have persistent episodes of noncardiac chest pain, and your healthcare provider has ruled out a cardiac cause, you may be diagnosed with noncardiac chest pain.
Noncardiac chest pain is defined as recurring pain in the chest – usually, behind the breastbone and near the heart – that is not related to your heart. In most people, noncardiac chest pain is actually related to problems with the esophagus, the most common being gastroesophageal reflux disease (GERD). Stress, anxiety, and depression can also manifest as chronic chest pain. Other conditions can cause acute chest pain in the short term, including lung problems and musculoskeletal injuries. However, noncardiac chest pain (NCCP) is diagnosed as a chronic condition.
What Could Be The Cause Of Chest Pain
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Noncardiac chest pain is often described as feeling like angina, which is chest pain caused by heart disease. It feels like there is painful pressure or tightness in the chest, or like pressure or weight, especially behind the breastbone. You may feel it on the right or left side or in the middle. Sometimes the pain radiates to the neck, left arm, or back. You may notice it occurs after eating, or accompanied by heartburn, a burning sensation in the chest. This can last for a few minutes or a few hours.
Inside your chest cavity (thorax), your esophagus actually runs right next to your heart. The same sensory nerves send pain signals from both organs to your brain. It is difficult to differentiate between the two based on symptoms alone. If you experience other symptoms of esophageal reflux, such as stomach fluid coming back up through your esophagus, that could be a clue. Other esophageal disorders, such as muscle spasms or visceral hypersensitivity, may be more difficult to identify.
Noncardiac chest pain affects up to 25% of U.S. adults. Between 50% and 75% of chest pain cases presenting to the emergency room are sent home without a cardiac diagnosis. These cases were classified as unexplained, caused by stress or anxiety, or as NCCP.
You may not be able to differentiate between a heart attack and noncardiac chest pain. Therefore, chest pain should always be taken seriously. If it occurs suddenly or is new and lasts more than five minutes, go to the emergency room. If the symptoms disappear after a few minutes, it may not be an emergency, but you should still see your healthcare provider as soon as possible to determine the cause. Noncardiac chest pain, whatever the cause, can always reoccur, and ultimately affect your quality of life.
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Noncardiac chest pain is most often associated with problems with the esophagus, the “swallowing tube” that connects the mouth to the stomach. There are several different esophageal disorders that can cause noncardiac chest pain, including:
When healthcare providers cannot determine the cause but have ruled out other possible factors, they diagnose “functional chest pain thought to originate from the esophagus.”
People with noncardiac chest pain generally have other symptoms of GERD, including heartburn and acid reflux. They also reported a high incidence of other gastrointestinal (GI) complaints, including sore throat, regurgitation, and difficulty swallowing. Up to 80% of those suffering from functional noncardiac chest pain report other functional gastrointestinal disorders without clear explanation, especially IBS (27%) and functional abdominal bloating (22%).
For some people, noncardiac chest pain is associated with psychological symptoms, such as stress, anxiety, and depression. This applies even when the cause is determined to be caused by something else. In fact, there is significant crossover between psychological symptoms and symptoms of esophageal hypersensitivity, as well as heartburn. Psychological stress can trigger gastrointestinal symptoms, and vice versa. Doctors speculate that this is caused by a disruption of the gut-brain connection.
When Should I Go To The Er For Chest Pain?
If you experience chest pain that resembles cardiac chest pain, you should immediately go to the emergency room. Upon arrival, you will receive a complete physical examination that measures all your vital signs, including blood pressure and heart rate. Then you will be checked to check for a heart attack or heart disease. Tests performed include an electrocardiogram (EKG) – a non-invasive test that records the electrical activity of your heart – and blood tests. Your heart releases certain proteins during a heart attack that will show up in blood tests. It is only when cardiac factors have been ruled out that you will be diagnosed with noncardiac chest pain.
Once your cardiologist or primary care provider has ruled out heart disease causes, you will likely be referred to a gastroenterologist next. They will test you for esophageal-based causes, starting with GERD. One way to test is to send you home on a proton pump inhibitor (PPI), a very effective drug for GERD. If a PPI relieves your symptoms, it can also confirm the cause. Other tests may include esophageal PH examination, esophageal motility test, upper endoscopy, or ultrasound. In addition to physical tests, your healthcare provider will take a medical history and ask about your stress and emotional factors.
If your noncardiac chest pain, like most people, is caused by GERD, treatment is usually simple and effective. Proton pump inhibitors (PPIs) are the most common medications used to treat GERD. PPIs reduce the amount of stomach acid your glands secrete, which also allows ulcers and acid corrosion to heal. Treatment usually starts with a high dose to control symptoms, then continues with a low dose for two to four months. PPIs are about 90% effective in treating GERD and its side effects. If it’s not effective, it’s likely your NCCP is caused by something else.
The next most common and effective treatment for noncardiac chest pain is medication that blocks pain signals. These usually come from a class of drugs known as tricyclic antidepressants (TCAs), which are used in much lower doses than those used to treat depression. If side effects prevent you from tolerating TCAs, other categories of antidepressants may work. Selective serotonin reuptake inhibitors (SSRIs) have shown promising results in treating NCCP, although these drugs are less well established than TCAs.
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Noncardiac chest pain may be associated with depression, anxiety, or stress. Psychotherapy can help you overcome this problem to reduce the occurrence of chest pain. Cognitive behavioral therapy (CBT) can teach you how to change or eliminate thought patterns that trigger stress or anxiety. Biofeedback is a guided mind-body therapy that can help you change the way your body responds to certain stimuli, including thoughts. You can also try stress management techniques at home, such as meditation, exercise, and relaxation.
Noncardiac chest pain can be scary, especially if it feels like heart-related chest pain. Recurring episodes can be frustrating and interfere with your quality of life. Always take chest pain seriously. Finding the cause of your chest pain may require some investigation, but it is worthwhile. Most causes, once identified, are easy to treat. Although pain is complex, there is a lot to learn about how your body responds to food, stress, and thoughts that can put you on the road to long-term recovery. When you experience chest pain, it can feel like your world is ending. . The intensity itself is often enough to make anyone panic. However, chest pain does not always indicate a heart attack or other serious condition. Often, this is caused by something less concerning. Here are some things you need to know about this condition and what to do if you experience it.
It can be described as pain in your chest area. For some people, it is located in the middle of the chest, while for others it is located on one side of the chest. Sometimes it can be accompanied by feelings of pressure, tightness, heaviness, or burning.
The source can be in various areas of the chest. It can come from the heart, lungs, or blood vessels. Chest pain can be short-term (acute), or long-lasting (chronic). It can also spread to the jaw and arms or to the back.
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If this is new, or you have other accompanying symptoms, you should see your doctor. The type of pain and other symptoms you experience can help determine the cause. For example, if you feel severe pain in your chest, accompanied by nausea and dizziness, it could be a sign of a heart attack.
Pain accompanied by shortness of breath could be a sign of a respiratory tract infection. Burning pain in the chest accompanied by fatigue and indigestion are signs of stomach ulcers. If in doubt, call an ambulance and get help immediately.
Chest pain is a common symptom that can be caused by various diseases. It can also be a symptom of anxiety, stress, or heart palpitations. If you experience chest pain, it is important to see a doctor to find out the cause and how to treat it. You should also make sure you know what the warnings are
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