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Don't worry, it's not a heart attack

Abraham Eisenstein, M.D. |
Chest pain is an alarming situation that often reminds people on heart attack and they rush to the hospital immediately. Fortunately, many people have chest pain that is not caused by the heart; they experience a form of non-cardiac chest pain.

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There is virtually no person that never experienced chest pain. Old and young, men and women, in some point in their life they will feel the pain which is not deadly but points to the condition in some chest organ. Both men and women are affected by it but this condition is twice as common in women, especially young and middle-aged women.

Non-cardiac chest pain may look like cardiac pain, which means that you must see the doctor if you have problem. The pain is usually in the middle of the chest and is characterized by a dull, burning or pressure sensation. It usually doesn't radiate into the neck, shoulders or arms.

The most common cause of non-cardiac chest pain arises from the esophagus. Esophageal causes of non-cardiac chest pain include gastroesophageal reflux disease (GERD) and esophageal 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.

Non-cardiac chest pain secondary to esophageal causes is worse during or after meals, when lying on the back, exercising or when experiencing anxiety. Other symptoms are often found including heartburn, acid regurgitation or difficulty swallowing and a feeling of food sticking in the middle of the chest. That pain can be located anywhere on the chest wall and many patients have multiple painful sites. Patients may also complain of muscle and joint aches, fatigue and difficulty sleeping.

Another common cause of non-cardiac chest pain is musculoskeletal problems, especially muscle inflammation. Finally, anxiety and panic attacks can produce chest pain that resembles the pain experienced during a heart attack. 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.

And now, the big question: how do you know if you have non-cardiac chest pain? Well, without the doctor you don't. We strongly advise against any home remedies on your own: although many people don't have heart attack, you don't know are you one of them. No chest pain should be treated without the medical supervision.

The doctor may require further testing including an exercise stress test, cardiac ultrasound or a cardiac angiogram. After heart disease is excluded, your medical history and physical exam should give your doctor the appropriate clues to the non-cardiac causes of your chest pain.

The good news: most patients can have complete relief of their symptoms if the appropriate cause of non-cardiac chest pain is identified. And how the causing conditions are treated? If you have GERD the treatment includes lifestyle changes, and drugs to control acid reflux.

In the case of musculoskeletal disorders the doctor will prescribe heating, stretching exercises, and nonsteroidal anti-inflammatory drugs. In the case of anxiety or panic attacks a few talks with the doctor and some drugs will solve the problem.

We can see that non-cardiac chest pain is usually easy to treat but we must be sure what the cause is.

Because, for example, a viral pneumonia and lung embolism (a blockage of the main artery of the lung) can also cause chest pain. You can easily recognize if you have those conditions: if you have chest pain with increased temperature and short breath, that's pneumonia and you should see the doctor. If you feel not ordinary pain but very strong chest pain that doesn't weakens - in any part of the chest - go to the doctor at once - you may have lung embolism and your life is in danger.

Therefore, we'll repeat: any kind of chest pain requires a visit to the doctor. And if you don't have heart problems rest assured, you will be OK in no time.

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