Non-Cardiac Chest Pain

What is it?

Non-cardiac chest pain is a feeling of having bothersome pain in your chest that is not a heart attack or coming from the heart. This pain can sometimes feel like a heart attack, so if you experience these symptoms, it is best to seek emergency care. Once it is known that the pain is not from your heart, the pain is called non-cardiac. This type of pain can be from reflux, food allergies in the esophagus, or esophageal motility disorders.

What are the symptoms?

The symptoms of non-cardiac chest pain are chest pain that may be associated with difficulty swallowing, pain when swallowing, regurgitation of food, or a sensation of food getting stuck.

How is it diagnosed?

Once it is determined that your chest pain is not from a heart attack or your heart, we typically perform an EGD or upper endoscopy, where a flexible camera is used to look at your esophagus and see if any changes are present that may explain your pain. Select samples are also taken at that time to test you for a food allergy called eosinophilic esophagitis (EoE). If further testing is needed, an esophageal manometry study is done using a special catheter that goes into your esophagus and measures how strong, fast, and coordinated your esophageal muscles are. This can help determine if the muscles in your esophagus are spasming and causing your chest pain or difficulty swallowing.

How is it treated?

Treatment for non-cardiac chest pain depends on what the underlying cause is. It can vary from medications and lifestyle modification to a variety of other procedure-based therapies.

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