Are Chest Pains Always Heart-Related?

You’ve seen it in dozens of movies. A guy suddenly screams in pain, clutches his chest or his left arm, and falls to the ground, writhing with a heart attack. That can certainly happen, but a heart attack can present in a number of different ways, especially among women. And just because you have chest pain, it doesn’t mean it’s heart-related.

At Northwest Houston Heart Center, cardiologists Dr. A. Adnan Aslam and Dr. Roy Norman understand that chest pain can have many different causes, not all of them cardiac-related. Taking a detailed medical history, evaluating your symptoms, and using various forms of diagnostic imaging, they can determine where your pain is coming from and what to do about it.

Heart-related causes of chest pain

Sometimes pain in the chest is related to the heart. The heart is responsible for supplying your body with oxygen-rich blood. If it can’t meet the demands made upon it, it sends out pain signals to let you know there’s a problem. Angina pectoris (Latin for chest pain) is chest pain related to those “problem alert” signals.

However, angina is merely a symptom of a heart disorder rather than a disorder itself.  If your doctor diagnoses it early, it can be treated and won’t cause any permanent damage. Unresolved angina can lead to heart attacks that cause permanent damage to the heart muscle, and, in about one-third of cases, unresolved angina causes sudden death.

Non-heart-related causes of chest pain

Non-cardiac chest pain (NCCP) is recurring pain in your chest, usually behind your breast bone and near your heart, that’s unrelated to your heart. NCCP affects up to 25% of adults in the US, and 50%-75% of chest pain cases at emergency rooms are discharged without a cardiac diagnosis. These are most commonly classified as unexplained, as stress- or anxiety-induced, or as the catchall NCCP.

NCCP is often related to a problem with your esophagus, the “swallowing tube” connecting your mouth to your stomach.

Within the chest cavity, the esophagus runs alongside the heart, and the same sensory nerves send pain signals to the brain from both organs, making it difficult to distinguish between the two based solely on symptoms Several esophageal disorders can cause NCCP, including:

• Gastroesophageal reflux disease (GERD), or chronic acid reflux: accounts for 50% to 60% of NCCP cases
• Esophageal muscle spasms: abnormal contractions
• Esophageal hypersensitivity: a sensory disorder in which the esophageal muscles, nerves, and receptors are overly sensitive; normal bodily sensations manifest as painful
• Esophageal inflammation: can result from an immune response to infection, food allergies, or peptic ulcer disease
• Abnormal esophageal tissue: creates constrictions, such as rings and webs

When providers can’t determine the exact cause but have ruled out other possibilities, they diagnose it as “functional chest pain of presumed esophageal origin.”

People with NCCP commonly report symptoms other than chest pain, especially of GERD, which leads to heartburn and acid reflux. They also have a higher incidence of other gastrointestinal (GI) problems, including sore throat, regurgitation, and difficulty swallowing, caused by stomach acid coming back up the esophagus.

And up to 80% of those with functional NCCP report other functional GI disorders that have no obvious explanation, especially irritable bowel syndrome (27%) and abdominal bloating (22%).

Other causes of NCCP

Some less common causes of NCCP include:

• Muscle strains or bone problems in the chest, chest wall, or spine (back)
• Chronic lung diseases, including diseases of the pleura (the tissue that covers the lungs)
• Pain disorders
• Psychological problems, including stress, anxiety, and depression

Some people even experience chest pain when the weather turns colder.

How do I know if my chest pain is serious?

The problem is, you have no way of telling if your chest pain is an indication of heart disease or blocked arteries, or if it’s due to a GI problem like GERD. The only way to know for sure is to come into Northwest Houston Heart Center for an examination and diagnostic tests, which will provide your doctor with the specifics they need to treat you effectively.

To get the process started, call us at any of our locations — in Tomball, Cypress, Magnolia, or The Woodlands, Texas — today, or book online. You can also text us at 832-402-9518.