Difference Between Cardiac And Non Cardiac Chest Pain

Chest pain is a common symptom that can be caused by various factors. It is important to distinguish between cardiac and non-cardiac chest pain as the underlying causes, diagnosis, and treatment may differ significantly.

Cardiac chest pain is caused by a heart condition, while non-cardiac chest pain stems from other causes. Cardiac chest pain originates from the heart and is usually accompanied by symptoms such as shortness of breath and arm or shoulder pain.

Cardiac chest pain is primarily linked to heart conditions and is usually a result of reduced blood flow to the heart muscles. Understanding these differences is crucial for effective response and management. Let’s dive in.

Cardiac And Non Cardiac Chest Pain

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Understanding The Difference Between Cardiac And Non-cardiac Chest Pain

While cardiac chest pain can indicate a serious and potentially life-threatening condition, non-cardiac chest pain may be caused by various non-life-threatening factors. Recognizing the symptoms and characteristics of both types of chest pain and using the key indicators for differentiation can help ensure appropriate medical evaluation and treatment.

Common Symptoms And Characteristics Of Cardiac Chest Pain

Cardiac chest pain typically arises from the heart or the blood vessels surrounding it. It is often caused by reduced blood flow or a blockage in the coronary arteries. 

Here are some key features of cardiac chest pain:

  • Location: Cardiac chest pain is typically felt in the center or left side of the chest. It can also radiate to the neck, jaw, shoulders, or arms.
  • Quality: The pain is often described as squeezing, pressure-like, or a tightness in the chest.
  • Duration: Cardiac chest pain may last for several minutes or longer, and it can occur even at rest or during minimal physical exertion.
  • Triggers: It is commonly triggered by physical activity, stress, or emotional distress.
  • Accompanying symptoms: Other symptoms may include shortness of breath, nausea, dizziness, sweating, and lightheadedness.

Key Indicators Of Non-cardiac Chest Pain

While non-cardiac chest pain does not originate from the heart or the surrounding blood vessels, it can still cause significant discomfort and anxiety. Identifying key indicators of non-cardiac chest pain can help avoid unnecessary cardiac interventions and provide appropriate management for the underlying cause.

Here are some key indicators of non-cardiac chest pain:

  • Location: Non-cardiac chest pain can occur anywhere in the chest area, including the upper, middle, or lower regions.
  • Quality: The pain may vary in nature, such as sharp, stabbing, burning, or aching.
  • Duration: Non-cardiac chest pain often lasts for seconds to minutes and may come and go over time.
  • Triggers: It can be triggered by certain movements, deep breathing, swallowing, or specific positions.
  • Accompanying symptoms: Non-cardiac chest pain may be associated with symptoms like acid reflux, indigestion, bloating, anxiety, or musculoskeletal discomfort.

Differentiating Factors And Diagnostic Criteria

Differentiating between cardiac and non-cardiac chest pain plays a crucial role in determining the appropriate diagnostic evaluation and treatment. Medical professionals employ various factors and diagnostic criteria to make accurate distinctions. Some critical points to consider include:

Differentiating Factors Diagnostic Criteria
Patient demographics Age, gender, medical history, risk factors
Pain characteristics Location, quality, duration, triggers
Accompanying symptoms Shortness of breath, nausea, dizziness, sweating, etc.
Additional diagnostic tests Electrocardiogram (ECG), cardiac enzymes, stress test, imaging studies, etc.

By carefully considering these differentiating factors and employing appropriate diagnostic criteria, medical professionals can distinguish between cardiac and non-cardiac chest pain accurately. This allows for targeted treatment plans and improved patient outcomes.

Cardiac Chest Pain: Causes And Risk Factors

In this section, I will explore the various heart conditions, lifestyle and genetic risk factors, and the influence of age and gender on the occurrence of cardiac chest pain.

Heart Conditions That Cause Cardiac Chest Pain

When it comes to cardiac chest pain, several heart conditions can be responsible for the discomfort and tightness experienced by individuals. These heart conditions include:

Heart Condition Description
Coronary artery disease (CAD) A condition characterized by the accumulation of plaque in the coronary arteries, leading to reduced blood flow to the heart.
Myocardial infarction (heart attack) An emergency condition that occurs when there is a sudden blockage in the coronary arteries, cutting off blood flow to the heart.
Valvular heart disease A condition where the heart’s valves do not function properly, causing abnormalities in blood flow and putting strain on the heart.
Cardiomyopathy A group of diseases that affect the heart muscle, leading to reduced heart function and an increased risk of chest pain.

Lifestyle And Genetic Risk Factors

In addition to heart conditions, certain lifestyle and genetic factors can heighten the risk of experiencing cardiac chest pain. These risk factors include:

  • Smoking: By damaging the blood vessels and reducing oxygen levels in the blood, smoking significantly increases the risk of developing coronary artery disease.
  • High blood pressure: Having consistently elevated blood pressure puts unnecessary strain on the heart, making it more susceptible to chest pain.
  • High cholesterol levels: Elevated levels of cholesterol contribute to the formation of plaque in the coronary arteries, leading to a reduced blood flow to the heart.
  • Obesity: Excessive body weight places additional stress on the heart, increasing the likelihood of chest pain.
  • Family history: Individuals with a family history of heart disease are genetically predisposed to develop cardiac chest pain.

Impact Of Age And Gender

Age and gender also play significant roles in the occurrence of cardiac chest pain.

  • Age: As individuals age, their blood vessels naturally become narrower and less flexible, increasing the risk of reduced blood flow to the heart and subsequent chest pain.
  • Gender: Men are more likely to experience cardiac chest pain at a younger age than women. However, after menopause, the risk for women increases due to hormonal changes.

Non-cardiac Chest Pain: Causes And Risk Factors

Non-cardiac chest pain differs from cardiac chest pain in that it is not caused by heart-related issues. Instead, it can be caused by various factors such as gastrointestinal problems, musculoskeletal issues, or anxiety. 

Non-cardiac chest pain refers to the discomfort or pain experienced in the chest that is not related to the heart. It can be caused by various factors, including digestive system disorders, musculoskeletal issues, and mental health conditions. Understanding these causes and risk factors is crucial in accurately diagnosing and treating non-cardiac chest pain.

Digestive System Disorders

Digestive system disorders are one of the common causes of non-cardiac chest pain. These disorders can include gastroesophageal reflux disease (GERD), gastritis, peptic ulcers, and esophageal spasms. GERD, in particular, occurs when stomach acid flows back into the esophagus, causing a burning sensation in the chest known as heartburn.

This can often be mistaken for cardiac-related chest pain. Other digestive issues like gastritis and peptic ulcers can also trigger chest pain and discomfort.

Musculoskeletal Issues

Musculoskeletal issues can also contribute to non-cardiac chest pain. Conditions like costochondritis, which is the inflammation of the cartilage that connects the ribs to the sternum, can cause sharp chest pain that may mimic a heart attack.

Additionally, chest muscle strain, rib fractures, and skeletal abnormalities can also lead to chest pain. These musculoskeletal causes should be considered when evaluating and diagnosing non-cardiac chest pain.

Mental Health Conditions And Stress

Mental health conditions, such as anxiety and depression, can manifest with physical symptoms, including chest pain. Stress and emotional distress can also trigger non-cardiac chest pain.

When a person experiences anxiety or undergoes high levels of stress, the body can release stress hormones that may cause chest pain or discomfort. It is important to consider the impact of mental health and stress on chest pain, as appropriate management of these factors can help alleviate symptoms. 

Diagnostic Tests For Cardiac Chest Pain

When experiencing chest pain, it is important to determine whether it is cardiac or non-cardiac in nature. 

1. Electrocardiogram (ECG)

An Electrocardiogram (ECG) is a common diagnostic test used to assess cardiac chest pain. It involves the placement of electrodes on the chest, arms, and legs to record the electrical activity of the heart.

The ECG provides valuable information about the heart’s rhythm and electrical patterns. It can help detect abnormalities, such as irregular heartbeats, ischemia (lack of blood flow to the heart), or evidence of a heart attack.

2. Cardiac Stress Tests

Cardiac stress tests are another diagnostic tool used to evaluate cardiac chest pain. These tests assess how the heart performs during physical activity or stress. One common type of stress test involves treadmill exercise, where the patient walks or runs on a treadmill while their heart activity is monitored.

Another type is a pharmacological stress test, where medications are used to simulate the effects of exercise on the heart. These tests help identify any abnormalities in the heart’s function, such as reduced blood flow or areas of ischemia.

3. Coronary Angiography

Coronary angiography is a more invasive diagnostic procedure used to visualize the coronary arteries. It involves the injection of a contrast dye into the arteries while X-ray images are taken.

This procedure can help identify any blockages or narrowings in the coronary arteries, which can cause chest pain. It provides detailed information about the extent and severity of coronary artery disease, helping guide treatment decisions.

4. Blood Tests for Cardiac Enzymes

Blood tests for cardiac enzymes are often performed when cardiac chest pain is suspected. These tests measure the levels of specific enzymes and proteins released by the heart when it is damaged or under stress. Elevated levels of these markers can indicate a heart attack or other heart-related conditions.

Examples of cardiac enzymes include troponin and creatine kinase-MB (CK-MB). Blood tests can help confirm or rule out cardiac causes of chest pain, aiding in the diagnosis and treatment process.

Diagnostic Tests For Non-cardiac Chest Pain

While cardiac chest pain is often the first concern, it’s important to consider other potential causes, including non-cardiac chest pain. Diagnostic tests play a crucial role in differentiating between cardiac and non-cardiac chest pain, allowing healthcare providers to accurately diagnose the underlying condition. 

Upper Endoscopy

Upper endoscopy, also known as esophagogastroduodenoscopy (EGD), is a diagnostic procedure that allows a healthcare provider to examine the upper digestive tract. This test involves inserting a thin, flexible tube with a light and camera at the end (endoscope) through the mouth and into the esophagus, stomach, and duodenum.

Upper endoscopy is particularly useful in evaluating non-cardiac chest pain that may be associated with gastroesophageal reflux disease (GERD), esophageal spasms, hiatal hernia, or other esophageal abnormalities.

Esophageal Manometry

Esophageal manometry is a diagnostic test that measures the strength and functioning of the esophageal muscles. It involves placing a thin, pressure-sensitive tube into the esophagus to record the muscle activity during swallowing.

By measuring the contractions and movements of the esophagus, esophageal manometry helps identify abnormalities such as esophageal motility disorders, which may contribute to non-cardiac chest pain.

Imaging Tests For Musculoskeletal Problems

Non-cardiac chest pain can also be caused by musculoskeletal problems, such as costochondritis or muscle strain. In such cases, imaging tests are commonly used to identify any abnormalities or injuries in the chest area. X-rays, CT scans, or MRI scans help visualize the bones, muscles, and soft tissues, providing valuable information for diagnosis and treatment planning.

Psychological Evaluations

Psychological factors can play a significant role in non-cardiac chest pain. Stress, anxiety, and depression can exacerbate or even cause chest pain unrelated to the heart. Therefore, psychological evaluations are often conducted to assess an individual’s mental and emotional well-being.

Through interviews and assessments, healthcare providers can identify any psychological factors that may contribute to the chest pain, ensuring a holistic approach to diagnosis and treatment.

Treatment Options For Cardiac Chest Pain

Depending on the severity of the condition, the healthcare provider may prescribe medications, suggest surgical interventions, or recommend lifestyle changes and cardiac rehabilitation. Let’s explore these treatment options in detail.

1. Medications For Heart Conditions

If you’re diagnosed with cardiac chest pain, your healthcare provider may prescribe medications to manage your heart condition effectively. These medications play a crucial role in alleviating symptoms, controlling blood pressure, reducing cholesterol levels, preventing blood clot formation, and managing irregular heart rhythms. Some commonly prescribed medications for heart conditions include:

Medication Function
Beta-Blockers Helps lower blood pressure and heart rate
Angiotensin-Converting Enzyme (ACE) Inhibitors Relaxes blood vessels and lowers blood pressure
Antiplatelet Drugs Prevents blood clot formation
Anticoagulants Reduces the risk of blood clots

2. Surgical Interventions

In more severe cases, where medication alone may not be sufficient, surgical interventions may be recommended to address the cardiac chest pain. These procedures aim to either improve blood flow to the heart or repair the damaged heart structures. Some common surgical options for treating cardiac chest pain include:

  • Coronary Artery Bypass Grafting (CABG): A surgical procedure that bypasses blocked or narrowed arteries to improve blood flow to the heart.
  • Angioplasty and Stent Placement: A minimally invasive procedure that involves inserting a stent to open up narrowed or blocked arteries and restore blood flow.
  • Heart Valve Surgery: In cases where the chest pain is caused by a faulty heart valve, surgery may be performed to repair or replace the valve, allowing proper blood flow.

3. Lifestyle Changes And Cardiac Rehabilitation

In addition to medications and surgical interventions, making certain lifestyle changes is crucial for managing cardiac chest pain and improving heart health. These changes include:

  1. Quitting smoking and avoiding exposure to secondhand smoke.
  2. Maintaining a healthy diet low in saturated and trans fats, cholesterol, and sodium.
  3. Engaging in regular physical activity as recommended by your healthcare provider.
  4. Limiting alcohol consumption.
  5. Managing stress through techniques like deep breathing, meditation, and yoga.
  6. Attending cardiac rehabilitation programs that focus on educating individuals about heart-healthy habits, exercise routines, and emotional support.

Treatment Options For Non-cardiac Chest Pain

Non-cardiac chest pain can often mimic symptoms of a heart condition, leading to understandable confusion and anxiety. However, once cardiac causes have been ruled out, there are various treatment options available to help alleviate the discomfort and manage non-cardiac chest pain effectively. 

Managing Digestive Disorders

One common cause of non-cardiac chest pain is related to digestive disorders, such as gastroesophageal reflux disease (GERD) or esophageal spasms. Thankfully, there are strategies that can help manage these digestive conditions, potentially reducing chest pain episodes. These strategies may include:

  • Eating smaller, more frequent meals to reduce pressure on the stomach
  • Avoiding trigger foods that may exacerbate symptoms, such as fatty or spicy foods
  • Identifying and avoiding food allergens or sensitivities
  • Practicing good posture during and after meals to minimize pressure on the abdomen
  • Keeping a food diary to track symptoms and identify potential trigger foods

Addressing Musculoskeletal Issues

Chest pain can also arise from musculoskeletal issues, particularly in the chest wall or surrounding muscles. These issues can range from muscle strain to costochondritis, inflammation of the cartilage connecting the ribs to the sternum. To address musculoskeletal chest pain, some options include:

  • Applying heat or cold packs to the affected area for pain relief
  • Taking over-the-counter pain medications, such as ibuprofen, as directed
  • Performing gentle stretching exercises to improve flexibility and reduce muscle tension
  • Engaging in physical therapy sessions to strengthen the muscles around the chest
  • Using supportive devices like posture braces to relieve strain on the chest wall

Psychological Therapies And Stress Management

Stress and psychological factors can contribute to non-cardiac chest pain, so it’s crucial to address these aspects as part of the treatment plan. Here are some psychological therapies and stress management techniques that may be helpful:

  • Cognitive-behavioral therapy (CBT) to identify and modify negative thought patterns related to chest pain
  • Relaxation techniques, such as deep breathing exercises or guided imagery, to promote overall calmness and reduce stress levels
  • Mind-body interventions like yoga or meditation to enhance mindfulness and foster a mind-body connection
  • Engaging in regular physical activity or exercise to release endorphins and promote emotional well-being
  • Seeking support from friends, family, or support groups to share experiences and gain coping strategies

Prevention And Self-care For Cardiac And Non-cardiac Chest Pain

Cardiac and non-cardiac chest pain may share similar symptoms, making it important to understand the differences between the two. While cardiac chest pain is related to issues with the heart, non-cardiac chest pain can be caused by various factors such as musculoskeletal problems, acid reflux, or anxiety. 

Cardiac Health Maintenance

In order to prevent and manage cardiac chest pain, it is essential to prioritize cardiac health. By adopting these simple measures and incorporating them into your daily routine, you can significantly reduce the risk of experiencing cardiac chest pain:

  1. Follow a well-balanced diet to maintain a healthy weight.
  2. Engage in regular physical activity such as brisk walking, jogging, or swimming, at least 30 minutes a day.
  3. Avoid smoking and limit alcohol consumption to moderate levels.
  4. Monitor and manage your blood pressure and cholesterol levels.
  5. Manage stress through relaxation techniques like deep breathing exercises or meditation.

Lifestyle Modifications To Reduce Risk

In addition to maintaining cardiac health, certain lifestyle modifications can help minimize the risk of both cardiac and non-cardiac chest pain. Consider implementing these changes into your daily routine:

  • Avoid excessive consumption of spicy and fatty foods, as they can trigger both acid reflux and cardiac symptoms.
  • Practice portion control and opt for a diet rich in fruits, vegetables, whole grains, and lean proteins.
  • Stay adequately hydrated throughout the day.
  • Engage in regular exercise to strengthen the muscles that support the chest and improve overall cardiovascular health.
  • Get sufficient sleep to promote overall well-being.

Coping Strategies For Non-cardiac Chest Pain

When experiencing non-cardiac chest pain, it is important to remember that it is typically not life-threatening, although it can be distressing. Here are some coping strategies to help manage non-cardiac chest pain:

  • Practice deep breathing exercises to promote relaxation and reduce anxiety.
  • Engage in activities that distract your mind from the pain, such as reading, listening to music, or pursuing a hobby.
  • Apply a warm compress or use over-the-counter pain relievers to alleviate discomfort caused by musculoskeletal issues.
  • Explore stress management techniques, such as yoga or mindfulness meditation, to help regulate stress and anxiety levels.
  • Seek support from a healthcare professional or therapist to address any underlying psychological factors contributing to non-cardiac chest pain.


Understanding the difference between cardiac and non-cardiac chest pain is crucial for prompt diagnosis and appropriate treatment. While cardiac pain is often associated with heart-related issues and requires urgent medical attention, non-cardiac pain may stem from various causes, ranging from musculoskeletal issues to gastrointestinal problems.

By being aware of the symptoms and seeking medical advice, individuals can better distinguish between the two and take the necessary steps towards managing their chest pain effectively.

FAQs Of Difference Between Cardiac And Non Cardiac Chest Pain

Can Non-cardiac Chest Pain Last For A Long Time?

Non-cardiac chest pain may last for hours or even days, depending on the underlying cause.

Is There A Difference In The Location Of Cardiac And Non-cardiac Chest Pain?

Yes, cardiac chest pain is usually felt in the center or left side of the chest, while non-cardiac chest pain can be felt anywhere in the chest.

Why Does Cardiac Chest Pain Often Radiate To The Left Arm?

Cardiac chest pain can radiate to the left arm because the heart and left arm share nerve pathways.

Can Non-cardiac Chest Pain Be Caused By Acid Reflux?

Yes, acid reflux is one of the common causes of non-cardiac chest pain.

What Are The Typical Symptoms Of Cardiac Chest Pain?

Symptoms of cardiac chest pain may include squeezing or tightness in the chest, shortness of breath, and nausea.

Can Anxiety Cause Non-cardiac Chest Pain?

Yes, anxiety can cause non-cardiac chest pain, as it can lead to muscle tension and increased sensitivity to pain.

How Can I Differentiate Between Cardiac And Non-cardiac Chest Pain In An Emergency?

It is crucial to seek immediate medical attention for any chest pain, as only a healthcare professional can accurately diagnose the cause.

Are There Any Risk Factors That Increase The Likelihood Of Experiencing Cardiac Chest Pain?

Risk factors for cardiac chest pain include smoking, high blood pressure, high cholesterol, and a sedentary lifestyle.

How Can Non-cardiac Chest Pain Be Treated?

Treatment for non-cardiac chest pain depends on the underlying cause and may involve lifestyle changes, medication, or even therapy for anxiety.

Is It Possible To Prevent Cardiac Chest Pain?

A10: Adopting a healthy lifestyle, managing stress, and regular exercise can help reduce the risk of cardiac chest pain.

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