It has been reported that 85% of hospital ER admissions for chest pain are not a heart attack. While it is difficult to completely differentiate symptoms of heartburn and a heart attack, how do you know when too much holiday cheer is just heartburn or something more serious, like a heart attack? Show
Heart attacks, in general, produce a continuous discomfort or pressure sensation in the center of your chest. The pain associated with heart attacks may be experienced as a burning, aching, squeezing, or heavy sensation that can spread to other areas of the body like the arm, shoulder, upper back or jaw. During a heart attack, there are symptoms present that are not generally felt during episodes of indigestion. Symptoms of a heart attack may include shortness of breath, sweating, light headedness, dizziness, and nausea. Indigestion generally causes temporary chest discomfort or burning anywhere from the upper abdomen to the throat. Heartburn usually hits after eating spicy, fatty, or greasy foods, but as with too much caffeine, feeling stressed, or eating too much. Symptoms may worsen when taking a deep breath or coughing, but the pain is often relieved by taking antacid medications. Symptoms are usually:
The good news is by making a few small dietary changes you can that can reduce run-ins with heartburn. 5 ways to prevent indigestion
While heart attacks may happen at rest, heart attack-related chest pain occurs more commonly during or immediately after exertion. Indigestion generally hits shortly after a meal or in the middle of the night. Noncardiac chest pain is chronic chest pain that feels like it’s in the heart, but it isn’t. It’s actually usually in the esophagus, which runs right alongside the heart. If you have persistent episodes of noncardiac chest pain, and your healthcare providers have ruled out cardiac causes, you may be diagnosed with noncardiac chest pain.
OverviewWhat is noncardiac chest pain?Noncardiac chest pain is defined as recurring pain in your chest — typically, behind your breast bone and near your heart — that is 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 is 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 is 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. Symptoms and Causes What are the most common causes of noncardiac chest pain?Noncardiac chest pain is most commonly related to a problem with your esophagus, the “swallowing tube” that connects your mouth to your stomach. There are several different esophageal disorders that can cause noncardiac chest pain, including:
When healthcare providers can’t determine the cause but have ruled out other possible factors, they diagnose “functional chest pain of presumed esophageal origin." What other problems can cause noncardiac chest pain?Some less common causes of noncardiac chest pain include:
Do people with noncardiac chest pain have other symptoms?People with noncardiac chest pain commonly have other symptoms of GERD, including heartburn and acid reflux. They also report a higher incidence of other gastrointestinal (GI) complaints, including sore throat, regurgitation and difficulty swallowing. Up to 80% of those with functional noncardiac chest pain report other functional GI disorders with no obvious explanation, especially IBS (27%) and functional abdominal bloating (22%). For some people, noncardiac chest pain is associated with psychological symptoms, such as stress, anxiety and depression. This is true even when the cause is determined to be something else. In fact, there is a significant crossover between psychological symptoms and symptoms of esophageal hypersensitivity, as well as heartburn. Psychological stress can trigger gastrointestinal symptoms, and vice versa. Doctors have speculated that this is due to a disorder of the gut-brain connection. What risk factors are associated with noncardiac chest pain?Correlation, but not causation, has been shown between noncardiac chest pain and:
Diagnosis and TestsHow is noncardiac chest pain diagnosed?If you experience chest pain that resembles cardiac chest pain, you should go to the emergency room. On arrival, you'll receive a complete physical exam that measures all of your vital signs, including blood pressure and heart rate. Then you’ll be screened for heart attack or heart disease. Tests include an electrocardiogram (EKG) — a noninvasive test that records your heart’s electrical activity — and blood tests. Your heart releases certain proteins when a heart attack occurs that will show up in a blood test. Only when cardiac factors have been ruled out will you be diagnosed with noncardiac chest pain. Once a cardiologist or your primary care provider has ruled out cardiac causes, you’ll likely be referred to a gastroenterologist next. They’ll test you for esophagus-based causes, starting with GERD. One way of testing is to send you home with a proton-pump inhibitor (PPI), a highly effective medicine for GERD. If the PPI relieves your symptoms, it can also confirm their cause. Other tests may include a PH study of the esophagus, an esophageal motility test, an upper endoscopy or ultrasound. In addition to physical tests, your healthcare provider will take a medical history and ask about your stress and emotional factors. Management and TreatmentHow is noncardiac chest pain treated?Effective treatment depends on identifying the cause of your noncardiac chest pain. Some options include: Acid reflux treatments If your noncardiac chest pain is, like most people’s, from GERD, treatment is usually simple and effective. Proton-pump inhibitors (PPI) are the most commonly used medicine to treat GERD. PPIs reduce the amount of stomach acid that your glands secrete, which also allows ulcers and acidic corrosion to heal. Treatment usually begins with a high dosage to control your symptoms, then continues with a low dosage for two to four months. PPIs are about 90% effective in treating GERD and its side effects. If they are ineffective, it probably means that your NCCP is caused by something else. Pain blockers The next most common and effective treatment for noncardiac chest pain is a medicine that blocks the pain signals. These are usually from a class of drugs known as tricyclic antidepressants (TCAs), used in much lower dosages than they are used to treat depression. If side effects prevent you from tolerating TCAs, other categories of antidepressants might work. Selective serotonin reuptake inhibitors (SSRI) have shown some promise in treating NCCP, although they are less well-established than TCAs. Emotional and behavioral therapies Noncardiac chest pain can be related to depression, anxiety or stress. Psychotherapy can help you to work through these problems to reduce the occurrence of chest pain. Cognitive behavioral therapy can teach you how to change or eliminate the thought patterns that trigger stress or anxiety. Biofeedback is a guided mind-body therapy that can help you change the way your body responds to certain stimuli, including thoughts. You can also try stress management techniques at home, such as meditation, exercise and relaxation. A note from Cleveland Clinic Noncardiac chest pain can be scary, especially when it feels like cardiac chest pain. Recurring episodes can be frustrating and interfere with your quality of life. Always take chest pain seriously. Finding the cause of your chest pain might take some investigation, but it’s worthwhile. Most causes, when they are identified, are simple to treat. When they are complex, there is a lot to be learned about how your body responds to foods, stress and thoughts that can put you on the path to long-term recovery. Share Facebook Twitter LinkedIn Email Print Last reviewed by a Cleveland Clinic medical professional on 04/04/2022. References
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Why do I feel shortness of breath after eating?Shortness of breath after eating can be an uncomfortable or distressing experience but is typically not a cause for concern. Possible causes include food allergies, inhaling food particles, and acid reflux. There are many possible reasons why a person may feel out of breath after eating.
How do you get rid of shortness of breath after eating?Avoiding Shortness of Breath When Eating. Eat for Energy.. Choose Easy-to-Chew Foods.. Opt for Smaller, More Frequent Meals.. Clear Your Airways Before Dining.. Go Slow.. Eat While Sitting Upright.. Use Pursed-Lip Breathing.. Save Beverages Until You're Done.. |
Chest pain and shortness of breath after eating
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