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What causes non-cardiac chest pain?

Dr. William B. Salt, MD
Gastroenterologist

The two most common causes of non-cardiac chest pain (NCCP) are:

  • Gastroesophageal Reflux Disease (GERD) - There are two main symptoms. Heartburn (pyrosis) is a burning feeling behind the breast bone. Regurgitation is feeling stomach juices coming back up into the chest and even to the mouth (often with a sour and acid-like taste). Some people with GERD experience NCCD, with or without the classic symptoms of heartburn and/or regurgitation.
  • Functional Chest Pain Syndrome - This is the medical diagnostic label developed by gastroenterologists applied to NCCP that is not considered a symptom of GERD, but which is a medically unexplained symptom. Medically unexplained symptoms are symptoms that doctors can't explain, because medical tests fail to show their cause. The term, functional refers to malfunction of how the body works. Functional chest pain syndrome is one of over 30 functional gastrointestinal (GI) disorders, known as FGIDs, the most common of which is irritable bowel syndrome. These functional symptom syndromes are collections of medically unexplained GI symptoms. The symptoms of these FGIDs commonly overlap with one another. Furthermore, they commonly co-occur with non-GI symptom syndromes, called functional somatic syndromes and chronic multisymptom illnesses. Examples of these symptom syndromes include, fibromyalgia, chronic fatigue, chronic pelvic pain, and interstitial cystitis (painful bladder). Medically unexplained symptoms and symptom syndromes are commonly associated with depression, anxiety, and/or panic as comorbidities.

Research is showing how the mind/brain and body communicate with one another, and that the central mind/brain can become sensitized to peripheral bodily pain signals. So these symptom syndromes are now being called, central sensitivity syndromes.

A new book, Still Hurting? FIND HEALTH! Discover What's Behind Your SYMPTOMS (That Doctors Can't Explain), by this author and co-written with Thomas L Hudson MDiv, JD proposes that a new unifying and integrated model of disease is necessary in order to understand how and why interrelated medically unexplained symptoms and symptom syndromes occur, including the NCCP/functional chest pain syndrome, and what people can do to help themselves and work effectively with their caring professionals.

Non-cardiac chest pain can be caused by a number of medical problems. Some types of chest pain are associated with injuries or other problems affecting the structures that make up the chest wall. Examples include:

  • Costochondritis - In this condition, the cartilage of the rib cage, particularly the cartilage that joins the ribs to the breastbone, becomes inflamed and painful.
  • Sore muscles - Chronic pain syndromes, such as fibromyalgia, can produce persistent muscle-related chest pain.
  • Injured ribs - A bruised or broken rib can cause chest pain.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.