Noncardiac Chest Pain

Illustration of the chest showing position of the ribs, sternum, trachea, lungs, and diaphragm.

In most cases, people who come to the emergency room with chest pain don’t have a problem with their heart. Instead, the pain is caused by other conditions. It's important for the healthcare team to be sure you are not having a life-threatening cause for chest pain such as:

  • Heart attack

  • Blood clot in the lungs

  • Collapsed lung

  • Ruptured esophagus

  • Tearing of the aorta

Once these major causes have been ruled out, you may have further evaluation for other causes of chest pain. These may be problems with the lungs, muscles, bones, digestive tract, nerves, or mental health. They include:

  • Inflammation around the lungs (pleurisy)

  • Collapsed lung (pneumothorax)

  • Lung inflammation (pleuritis or pneumonitis)

  • Fluid around the lung (pleural effusion)

  • Lung cancer (rare cause of chest pain)

  • Inflamed cartilage between the ribs (costochondritis)

  • Fibromyalgia

  • Rheumatoid arthritis

  • Chest wall strain

  • Reflux

  • Stomach ulcer

  • Spasms of the esophagus

  • Gall stones

  • Gallbladder inflammation

  • Panic or anxiety attacks

  • Emotional distress

Your pain doesn’t seem to be coming from your heart. But sometimes the signs of a serious problem take more time to appear. Continue to watch for the warning signs listed below.

Home care

Follow these guidelines when caring for yourself at home:

  • Rest today and don't do any strenuous activity.

  • Take any prescribed medicine as directed.

Follow-up care

Follow up with your healthcare provider as advised.

Call 911

Call 911 if any of these occur:

  • A change in the type of pain: if it feels different, becomes more severe, lasts longer, or begins to spread into your shoulder, arm, neck, jaw or back

  • Shortness of breath or increased pain with breathing

  • Weakness, dizziness, or fainting

  • Rapid heart beat

  • Crushing sensation in your chest

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Cough with dark colored sputum (phlegm) or blood

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider

  • Swelling, pain or redness in one leg

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