What is non-cardiac chest pain?
Non-cardiac chest pain is chest pain or discomfort that is not caused by a heart condition. Because chest pain can sometimes be a sign of a heart problem, it is important to have any new or concerning chest pain evaluated by a healthcare provider. Once heart-related causes have been ruled out, your provider may determine that your symptoms are due to a gastrointestinal or another non-cardiac condition.

Non-cardiac chest pain can vary from person to person. It may feel like:

  • Pressure or fullness in the chest
  • Burning discomfort
  • Aching or soreness
  • Squeezing or tightness
  • Sharp or dull pain

Symptoms may occur during swallowing, eating, exercise, movement, or breathing, and can range from mild to severe.

What causes non-cardiac chest pain?
There are several possible causes of non-cardiac chest pain. The most common gastrointestinal causes include:

Other causes may include:

  • Muscle or chest wall inflammation
  • Lung conditions
  • Stress, anxiety, or panic disorders

Your provider will work to identify the underlying cause so the most appropriate treatment can be recommended.

Symptoms of non-cardiac chest pain
Symptoms vary depending on the underlying cause and may include:

  • Chest pain or discomfort
  • Burning in the chest
  • Pressure or tightness
  • Pain that occurs with swallowing
  • Difficulty swallowing
  • Pain after eating
  • Symptoms related to stress or anxiety

Because symptoms can overlap with heart disease, prompt medical evaluation is important for new or worsening chest pain.

Diagnosing non-cardiac chest pain
Your provider will review your symptoms and medical history, and perform a physical exam. Testing is often recommended after cardiac causes have been excluded.

Testing may include:

  • Chest X-ray or CT scan
  • Upper endoscopy (EGD)
  • Trial of acid-reducing medication
  • Esophageal pH monitoring
  • High-resolution esophageal manometry
  • Barium swallow (esophagram)

These tests help determine whether your symptoms are related to acid reflux, an esophageal motility disorder, esophageal hypersensitivity, or another condition.

Treatment for non-cardiac chest pain
Treatment depends on the underlying cause of your symptoms.

Treatment options may include:

  • Acid-reducing medications for gastroesophageal reflux disease (GERD)
  • Dietary and lifestyle changes
  • Medications that relax the muscles of the esophagus
  • Neuromodulator medications to reduce esophageal nerve sensitivity
  • Cognitive behavioral therapy (CBT) or other behavioral therapies
  • Treatment for muscle or chest wall pain
  • Stress management strategies and treatment for anxiety when appropriate

Your provider will work with you to develop an individualized treatment plan based on the cause of your symptoms.

When to seek care
Contact your healthcare provider if you experience:

  • Persistent or recurring chest pain
  • Pain with swallowing
  • Difficulty swallowing
  • Chest pain that does not improve with treatment
  • New or worsening symptoms

Seek emergency medical care immediately if your chest pain:

  • Spreads to your arm, jaw, neck, or back
  • Is severe or different from previous episodes
  • Is accompanied by shortness of breath, dizziness, fainting, sweating, or nausea

These symptoms may indicate a heart-related emergency and should be evaluated immediately.

Contact us
If you have questions about non-cardiac chest pain or treatment options, please contact our office at 612-871-1145.