Knee Pain

Noncardiac chest pain is defined as recurring pain in your chest — typically, behind your breast bone and near your heart — that’s not related to your heart. In most people, noncardiac chest pain is actually related to a problem with their esophagus, most often gastroesophageal reflux disease (GERD). Stress, anxiety and depression can also manifest as chronic chest pain. Other conditions can cause short-term, acute chest pain, including lung problems and musculoskeletal injuries. But noncardiac chest pain (NCCP) is diagnosed as a chronic condition.

What does noncardiac chest pain feel like?

Noncardiac chest pain is often described as feeling like angina, the chest pain caused by heart disease. It feels like a painful squeezing or tightness in your chest, or like pressure or heaviness, particularly behind your sternum. You may feel it on the right side or the left side or in the middle. Sometimes the pain radiates to your neck, left arm or back. You may notice that it occurs after eating, or that it’s accompanied by heartburn, a burning sensation in the chest. It can last for a few minutes or a few hours.

Why does pain in the esophagus feel like heart pain?

Inside your chest cavity (thorax), your esophagus actually runs right alongside the heart. The same sensory nerves send pain signals from both organs to your brain. It can be difficult to distinguish between the two based on symptoms alone. If you have other symptoms of esophageal reflux, such as stomach fluid coming back up through your esophagus, that can be a clue. Other esophageal disorders, such as muscle spasms or visceral hypersensitivity, might be trickier to identify.

How common is noncardiac chest pain?

Noncardiac chest pain affects up to 25% of adults in the U.S. Between 50% and 75% of chest pain cases presenting to emergency rooms are discharged without a cardiac diagnosis. These cases are classified either as unexplained, as stress- or anxiety-induced or as NCCP.

How do I know if my chest pain is serious?

You may not be able to tell the difference between a heart attack and noncardiac chest pain. For this reason, you should always take chest pain seriously. If it’s sudden or new and lasts longer than five minutes, go to the emergency room. If it goes away 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 occur again, and can end up affecting your quality of life.