Do you sometimes feel a tightness , tightness, or pain in your chest? We often get scared when we feel like something is wrong with our heart, right? But did you know, not all chest pain is caused by the heart. Sometimes when you go to a doctor, they do tests and say, 'There's no problem with the heart.' So what's going on? That's what we're going to talk about today, chest pain that is not related to the heart. This is medically called `Noncardiac Chest Pain (NCCP)`.
So, what is this noncardiac chest pain?
Simply put, `Noncardiac Chest Pain (NCCP)` is a pain that occurs frequently in your chest, especially in the middle of the chest, where the heart is. However, this is not caused by any heart disease. For many people, the main reason for this kind of pain is a problem with the esophagus (the tube that carries food from the mouth to the stomach when we swallow). Among them, a condition called `Gastroesophageal Reflux Disease (GERD)` is the most common. Among us, this is an exacerbation of "gastritis" or "reflux", right? In addition, things like stress, anxiety, and depression can also appear as persistent chest pain. Sometimes, things like lung problems and muscle spasms can also cause chest pain suddenly. But `NCCP` is recognized as an ongoing, chronic condition.
What does this pain feel like? Is it like a heart attack?
Yes, most of the time, this non-cardiac chest pain feels like angina . It can feel like someone is squeezing your chest, squeezing it, or a heavy weight is placed on your chest. This pain is most often felt behind the middle bone of your chest (sternum) . Sometimes it can be on the right side, left side, or right in the middle. Just like a heart attack, this pain can also feel like it's going to your neck, left arm, or back.
You may be able to understand something else with these things. For example, this pain may come after you finish eating. Or, a burning sensation in the chest, which we call "heartburn" , can come with this pain. This pain can last for a few minutes, or sometimes it can last for a few hours.
Imagine, you eat a good dinner, with a little spice, and after a while, when you go to bed, you feel a burning sensation in the middle of your chest. Some people think, 'It must be gas.' But if this happens frequently, it can be a symptom of `GERD`, which can also cause chest pain.
Why does throat pain feel like heartache?
This may seem strange, but there is a reason for it. Inside our chest cavity ``(thorax),`` the esophagus is located very close to the heart . Pain signals from both organs are carried to the brain by the same sensory nerve system. Therefore, it is sometimes very difficult to distinguish these two pains based on symptoms alone.
However, if you have other symptoms related to esophageal reflux, which is when you feel like stomach contents are coming back up your esophagus, that could be a sign that the pain is not related to your heart. However, conditions like muscle spasms in your esophagus or visceral hypersensitivity can be a little harder to identify.
How common is this condition?
This non-cardiac chest pain is more common than we think. According to some reports, about 25% of adults suffer from this condition. Between 50% and 75% of people who come to the emergency room with chest pain are sent home after being diagnosed with a heart condition. Often, these cases are classified as unexplained, caused by stress or anxiety, or as ``NCCP.''
How do you know if chest pain is serious?
This is the most important thing. You may not be able to tell the difference between a heart attack and non-cardiac chest pain on your own. Therefore, any chest pain should be taken seriously.
- If the pain starts suddenly and lasts more than five minutes, definitely go to an emergency room immediately.
- Even if the pain goes away in a few minutes and it's not an emergency, it's very important to see a doctor as soon as possible to find out what's causing it.
Remember, non-cardiac chest pain, regardless of the cause, can recur. It can also affect your quality of life.
What are the main causes of chest pain that is not related to the heart?
As we mentioned earlier, this `NCCP` condition is often caused by a problem with your esophagus (the tube that carries food from your mouth to your stomach). There are several diseases of the esophagus that can affect this:
Gastroesophageal Reflux Disease (GERD)
This is the most common cause . Between 50 and 60 percent of NCCP patients have this condition. Simply put, this is when stomach acid comes up the esophagus.
Esophageal muscle spasms
This type of pain can also occur due to abnormal, overactive contractions of the muscles in the oesophagus. It can also occur in the oesophagus, just like a lump in the leg.
Achalasia
This is a rare condition. What happens here is that the valve (sphincter) at the lower end of the esophagus does not open properly. Then food cannot pass into the stomach and gets stuck in the esophagus.
Esophageal hypersensitivity
This is a sensory disorder. That is, the muscles, nerves, and receptors in the walls of the esophagus become overly sensitive. Even pressure, pulling, and acid that are normally felt are felt as pain by these people.
Inflammation of the esophagus
Infections, food allergies (e.g., eosinophilic esophagitis) , or peptic ulcer disease can cause the esophagus to become inflamed and injured, which can also cause chest pain.
Abnormal tissue in the esophagus
Sometimes, abnormal tissue, such as rings or webs, can grow inside the esophagus, blocking the esophagus.
Sometimes doctors can't find any of these causes. But when it's confirmed that there's no heart problem, it's called "functional chest pain of presumed esophageal origin."
What other things can cause chest pain like this?
In addition to problems with the esophagus, there are other reasons why this `NCCP` condition can occur. However, these are less common:
- Muscle or bone problems in the chest, chest wall, or spine. Like a pulled muscle or a problem with a rib.
- Chronic lung diseases, especially those involving the pleura, the membrane that covers the lungs.
- Stomach problems, for example stomach ulcers.
- Mental problems. Things like pain disorders, stress, anxiety, and depression .
Are there any other symptoms along with this chest pain?
Yes, many people with non-cardiac chest pain also have other symptoms related to GERD. For example, heartburn and acid reflux. Other digestive complaints, such as sore throat, regurgitation, and difficulty swallowing, are also common. About 80% of people with functional NCCP have been found to have other functional digestive disorders with no clear cause. The most common of these are Irritable Bowel Syndrome (IBS) (about 27%) and functional abdominal bloating (about 22%).
For some people, this chest pain is also associated with psychological symptoms. That is, things like stress, anxiety, and depression. Even if the cause of the pain is found to be something else, this psychological aspect can also be related to it. In fact, there is a strong connection between psychological symptoms and esophageal hypersensitivity, as well as chest inflammation. Stress can cause digestive system symptoms, and those symptoms can in turn increase stress. Doctors believe that this may be due to some weakness in the gut-brain connection between our intestines and brain .
What risk factors influence this?
Although not a direct cause, these factors have been found to be associated with non-cardiac chest pain:
- High Body Mass Index (BMI) - This means having more weight than is appropriate for your height.
- Smoking or tobacco use.
- `NSAIDs` (Nonsteroidal Anti-inflammatory Drugs) - This means frequent use of non-steroidal anti-inflammatory drugs (e.g. painkillers such as ibuprofen and diclofenac).
- Anxiety .
How is this condition diagnosed?
If you are experiencing chest pain that is similar to a heart attack, the first thing you should do is go to the emergency room. There, they will take all the vital signs, such as your blood pressure and heart rate, and do a complete physical exam. Then, they will check for a heart attack or heart disease. This will include an `EKG (Electrocardiogram)` test (a painless test that records the electrical activity of the heart) and blood tests. These blood tests can detect the presence of certain proteins that are released by the heart during a heart attack. Only after it is confirmed that there is no heart problem, will you be diagnosed with ``non-cardiac chest pain'' (NCCP).
After a cardiologist or your family doctor confirms that there is no heart problem, they will likely refer you to a gastroenterologist . He or she will check for esophageal conditions, especially GERD.
One way to do this is to prescribe a medication called a proton-pump inhibitor (PPI) . These are very effective medications for GERD. If your symptoms improve after using this medication, it may help to determine the cause.
Other tests may include a pH study of the esophagus , an esophageal motility test , an upper endoscopy, or an ultrasound . In addition to these physical tests, the doctor will ask about your medical history and discuss your stress and emotional factors.
What are the treatments for this?
To provide effective treatment, you need to find the exact cause of your non-cardiac chest pain. There are several treatment options:
Acid reflux treatments
If, like most people, your NCCP is caused by GERD, treatment is usually simple and effective. Proton pump inhibitors (PPIs) are the most commonly used medications for GERD. PPIs work by reducing the amount of acid produced by the stomach glands. This helps to heal the ulcers and reduce the damage caused by the acid. Treatment usually starts with a high dose to control symptoms. Then, a lower dose is continued for two to four months. PPIs are about 90% effective in treating GERD and its side effects. If these don't work, your NCCP may be caused by something else.
Pain blockers
The next most commonly used effective treatment is pain-blocking drugs. These usually belong to a class of drugs called tricyclic antidepressants (TCAs) . However, they are given at much lower doses than those used for depression. If you find the side effects of TCAs difficult to tolerate, other types of antidepressants may also help. Selective serotonin reuptake inhibitors (SSRIs) have shown some success with NCCP, but they are not as well-established as the TCAs.
Emotional and behavioral therapies
We've mentioned that chest pain that isn't related to the heart can sometimes be related to depression, anxiety, or stress. Psychotherapy can help address these issues and reduce the frequency of chest pain. Cognitive Behavioral Therapy (CBT) teaches you to change or eliminate thought patterns that cause stress or anxiety. Biofeedback is a guided mind-body therapy. It helps you change the way your body responds to certain stimuli (including thoughts). You can also try stress management techniques at home (e.g., meditation, exercise, relaxation techniques).
Finally, things to remember (Take-Home Message)
Chest pain can be a scary thing, especially when it feels like it's coming from a heart condition. Having this kind of pain on a regular basis can be distressing and can interfere with your ability to enjoy life.
Therefore, if you experience persistent chest pain, take it seriously. Don't delay seeking medical advice.
Finding the cause of your chest pain may take some effort and some testing. But it's worth it. Because most of the time, once you find the cause, it's very simple to treat. Even if the cause is a little complicated, you can learn a lot about how your body responds to food, stress, and thoughts. That knowledge will help you on your way to long-term recovery. So, take care of your physical health.
` Chest pain, Heart disease, GERD, Esophagus, Stress, Digestive system, Noncardiac Chest Pain
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න