NON-CARDIAC CHEST PAIN

Both young and old, have intermittent chest pain. Chest pain can be alarming, as it might indicate severe heart disease or even a heart attack. However many people (and most young people) have chest pain that is not caused by the heart – this is called non-cardiac chest pain. The most common cause of non-cardiac chest pain arises from a nearby organ, the esophagus (food pipe). Esophageal causes of non-cardiac chest pain include gastroesophageal reflux disease (GERD) and gastroesophageal spasm. GERD results from stomach acid backing up into the esophagus, which produces heartburn and chest pain. Esophageal spasm is caused by chaotic muscle contractions of the lower esophagus aggravated by acid reflux, stress, or unknown factors. Another common cause of non-cardiac chest pain is musculoskeletal problems, especially fibromyositis (muscle inflammation). Finally, anxiety and panic attacks can produce chest pain that resembles the pain experienced during a heart attack. The chest pain is usually in the middle of the chest and is characterized by a dull, burning, or pressure sensation. The pain usually does not radiate into the neck, shoulders, or arms. Non-Cardiac chest pain secondary to esophageal causes is made worse during or after meals, when lying on the back (supine position), exercising, or when experiencing anxiety. Associated symptoms are often found including heartburn, acid regurgitation or difficulty swallowing, and a feeling of food sticking in the middle of the chest (dysphagia). Non-Cardiac chest pain secondary to musculoskeletal disorders can be located anywhere on the chest wall (multiple painful sites are common). Patients may also complain of muscle and joint aches, fatigue, and difficulty sleeping. The chest pain associated with anxiety and panic attacks is accompanied by a feeling of impending doom, shortness of breath, heart palpitations, sweating, and insomnia. Most patients can have complete relief of their symptoms if the appropriate cause of non-cardiac chest pain is identified.

Some Non-Cardiac Causes for Chest Pain

Gastrointestinal Causes – the Digestive Tract: Usually burring in nature, this pain gets relieved with antacids like digene. Pains originating from the digestive tract often can mimic heart pains.

Musculoskeletal Causes: Typically sharp and confined to a specific area of the chest. They may be brought on by the movement of the chest and/or arms into certain positions, and often are relieved by changing position.

Causes in the Lungs: The pain of pneumonia and pleuritis are often made worse by deep breaths or coughing. The pain of pneumothorax may be felt more acutely with deep breaths or may be made better or worse by assuming certain positions. Like

Aortic Dissection: Often described by survivors as the worst pain they ever experienced, the pain of aortic dissection may last hours, even days.

Nerve Impingement – Cervical Spondylosis: Cervical Spondylosis is the disease of the bones of the neck. A disease commonly associated with aging, it results in a lack of flexibility of these bones and flexibility of these bones and narrowing of the spaces which are present in between two spaces.

Shingles – Herpes: Because of the onset of discomfort or pain associated with shingles can precede the appearance of vesicles by several days, a person can experience pain in a certain area of the chest for several days before the cause becomes apparent.

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