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Noncardiac Chest Pain

Medically reviewed by Last updated on Jan 5, 2023.

What do I need to know about noncardiac chest pain?

Noncardiac chest pain is pain or discomfort in your chest that is not caused by a heart problem. The pain may move to your neck, back, or other areas. Pain from another area can also move to your chest.

What causes or increases my risk for noncardiac chest pain?

  • Acid reflux
  • Nerve or muscle problems within the esophagus that slow the movement of food
  • Sickle cell crisis, if you have sickle cell disease
  • Increased sensitivity to pain within your esophagus
  • Panic attacks, anxiety, or depression
  • Chest wall, muscle, or rib pain
  • A blood clot in your lung, called a pulmonary embolism (PE)

How is the cause of noncardiac chest pain diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Describe your chest pain in as much detail as possible. Tell him or her where your pain is and when it began. Tell the provider if you notice anything that makes the pain worse or better. Tell him or her if it is constant or comes and goes. Also include any other symptoms you have with the chest pain, such as sweating or nausea. Your provider will ask about any medicines you use and medical conditions you have. You may also need any of the following:

  • Blood tests check for possible causes of noncardiac chest pain, such as an infection.
  • pH monitoring is used to check your throat for acid reflux.
  • Manometry measures the pressure within the esophagus. This test may show nerve or muscle problems that cause slow movement of food.
  • An ultrasound, x-ray, CT, or MRI scan may show the cause of your chest pain, such as a PE. You may be given contrast liquid to help an area show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the provider if you have any metal in or on your body.
  • An endoscopy may be done to check for ulcers or problem with your esophagus.
    Upper Endoscopy

How is noncardiac chest pain treated?

Treatment depends on the cause of your chest pain. You may need any of the following:

  • Medicines may be given to treat the cause of your chest pain. You may be given medicines to decrease pain, relieve anxiety, decrease acid reflux, or relax muscles in your esophagus.
  • Cognitive therapy may be helpful if you have panic attacks, anxiety, or depression. It can help you change how you react to situations that tend to trigger your chest pain.
  • Surgery may be needed for certain causes of chest pain, such as a PE or a digestion problem. Surgery may also be needed to repair an injured area causing pain.

What are some healthy living tips?

If the cause of your chest pain is known, your healthcare provider will give you specific guidelines to follow. The following are general healthy guidelines:

  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Choose a variety of healthy foods as often as possible. Include fresh, frozen, or canned fruits and vegetables. Also include low-fat dairy products, fish, chicken (without skin), and lean meats. Your healthcare provider or a dietitian can help you create meal plans. You may need to avoid certain foods or drinks if your pain is caused by a digestion problem.
    Healthy Foods
  • Lower your sodium (salt) intake. Limit foods that are high in sodium, such as canned foods, salty snacks, and cold cuts. If you add salt when you cook food, do not add more at the table. Choose low-sodium canned foods as much as possible.

  • Ask about activity. Your healthcare provider will tell you which activities to limit or avoid. Ask when you can drive, return to work, and have sex. Ask about the best exercise plan for you.
  • Maintain a healthy weight. Ask your healthcare provider what a healthy weight is for you. Ask him or her to help you create a weight loss plan if you are overweight.
  • Ask about vaccines you may need. Your healthcare provider can tell you which vaccines you need, and when to get them. He or she may recommend these and other vaccines:
    • The influenza (flu) vaccine is given each year. Get a flu vaccine as soon as recommended, usually in September or October.
    • The pneumonia vaccine is usually given every 5 years. Your healthcare provider may recommend the pneumonia vaccine if you are 65 or older.
    • COVID-19 vaccines are given to adults as a shot in 1 or 2 doses. Vaccination is recommended for all adults. A booster (additional) dose is also recommended for all adults. A second booster is recommended for all adults 50 or older and for immunocompromised adults 18 or older. The second booster is also recommended for adults who received the 1-dose vaccine for the first and booster doses. Your healthcare provider can tell you when to get one or both boosters.

When should I seek immediate care?

  • You have severe chest pain.

When should I call my doctor?

  • Your chest pain does not get better, even with treatment.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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