- Chest pain is not always a sign of a heart attack and can indicate other conditions
- GERD causes burning chest pain, worsens after meals, and improves with antacids
- Muscle strain leads to achy chest pain, worsened by arm movement or deep breaths
Heart attack is one of the leading causes of deaths across the globe. This along with stroke contribute to 85% of all deaths caused by cardiovascular diseases, according to the World Health Organisation (WHO). One of the earliest symptoms of a heart attack is chest pain. Hence, whenever a person experiences chest pain, their first assumption is that it is a heart attack. However, that is not always true. A chest pain is not always a sign of a heart attack, and can be a sign of several other conditions. Understanding this can help you to address the issue.
Conditions That Cause Chest Pain Other Than Heart Attack
1. GERD (Acid Reflux)
Gastroesophageal reflux disease (GERD) happens when stomach acid flows back into the oesophagus. This irritates the lining and causes a burning sensation in the chest known as heartburn. This pain might feel like a sharp or burning stab and it can worsen after meals, when lying down, or bending over. In some cases, it can last a few minutes, in others, a few hours. Unlike heart attack pain, acid reflux usually comes with sour taste in the mouth, regurgitation, bloating, or throat irritation, and improves with antacids.
GERD affects millions worldwide, including many in India due to spicy diets and irregular eating habits common in urban lifestyles like Delhi's fast-paced routines. Risk factors include obesity, smoking, hiatal hernia, and pregnancy. Diagnosis involves endoscopy or pH monitoring, while lifestyle changes like smaller meals, avoiding triggers (e.g., caffeine, tomatoes), elevating the bed head, and medications such as proton pump inhibitors (PPIs) like omeprazole provide relief. Persistent cases may need surgery. Always rule out cardiac issues first, as GERD is the top non-cardiac cause.
2. Costochondritis
This is inflammation of the cartilage connecting ribs to the breastbone (sternum), which causes sharp and localised chest pain. This can worsen with movement, deep breaths, coughing, or pressing on the area. Injury, repetitive strain like heavy lifting, intense yoga, viral infections, or arthritis, can trigger it.
This condition is common in fitness enthusiasts practicing yoga or cardio. Treatment focuses on rest, ice/heat packs, NSAIDs like ibuprofen for pain and swelling, and physical therapy to strengthen chest muscles.
3. Muscle Strain
This happens when chest wall muscles or intercostal muscles (between ribs) get overstretched from overuse, poor posture, sudden twists, or trauma. The pain is achy or sharp and worsens with arm movement, twisting, or breathing deeply. It improves with rest and is different from constant cardiac pressure. It may happen after workouts or coughing fits.
This is prevalent among those with desk jobs or active lifestyles involving yoga stretches. It responds well to RICE (Rest, Ice, Compression, Elevation), gentle stretching, and over-the-counter pain relievers.
4. Anxiety/Panic Attacks
Anxiety or panic disorders can lead to chest tightness, sharp pain, or pressure due to hyperventilation, muscle tension, and adrenaline surges. This mimics heart attacks with added rapid heartbeat, dizziness, sweating, and fear. Anxiety attacks peak in 10 minutes and subside, and are usually linked to stress without physical exertion. It is common in high-stress environments and therapy like CBT, breathing exercises like the 4-7-8 technique, and medicines can help manage it
5. Pleurisy/Pneumonia
Pleurisy inflames the lung lining (pleura), causing stabbing pain, which increases while breathing, coughing, or sneezing. It usually occurs due to viral infections, pneumonia, or autoimmune issues. Pneumonia can also lead to fever, cough with phlegm, and fatigue. This pain is usually one-sided, unlike central heart pain. Antibiotics can treat bacterial pneumonia along with rest and NSAIDs.
6. Gallstones
Gallstones block bile ducts, causing intense upper right chest/abdominal pain. It can radiate to the back or shoulder, especially after high-fat meals, with nausea or vomiting. Unlike heart attack pain, this is episodic and lasts for 30 minutes to a few hours. Painkillers, ursodeoxycholic acid helps dissolve small stones, or surgery removes the gallbladder.
7. Peptic Ulcer
Ulcers erode stomach/duodenum lining, causing burning epigastric pain that may radiate to the chest. It can be worsened due to an empty stomach or spicy food. You can get relief by eating or taking antacids. PPIs and antibiotics can help eradicate the causes.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
