Chest pain may be caused by heart disease (cardiac) or it may be caused by a condition which has nothing to do with your heart (noncardiac).

Noncardiac causes of chest pain include: diseases of the esophagus, peptic ulcer disease, gallbladder disease, pancreatitis, muscle or bone problems, hyperventilation, anxiety, and pneumonia and other lung diseases.

Cardiac causes of chest pain include: coronary artery disease, myocardial infarction (heart attack), aortic dissection (tear in the aorta), pericarditis (inflammation of the lining around the heart), and mitral valve prolapse (bowing of one of the heart's four valves).

If you have recently undergone surgery for the heart, lungs or other organs located in the chest, you may experience pain as part of the healing process. Chest wall pain may also be produced by coughing due to cigarette smoking or illness.

• What is angina pectoris?
• Is all chest pain alike?
• If I complain of chest pain, what will my doctor do?
• What should I do if I experience new or unusual chest pain?
• How is chest pain treated?

What is angina pectoris?
Coronary artery disease is a cardiac condition which may cause chest pain. This pain is called, "angina pectoris" or "angina". If you have angina, you probably experience pain or discomfort during or immediately after exertion, after heavy meals, during sudden intense stress or anger, or during exposure to cold.

Is all chest pain alike?
The experience of chest pain and discomfort differs from individual to individual and varies according to the source of the pain. The severity of the chest pain sometimes has little to do with the seriousness of the underlying illness.

If I complain of chest pain, what will my doctor do?
Your doctor will conduct a complete history and physical examination. He may suspect cardiac or noncardiac sources of pain. To help diagnose cardiological problems, he will ask you questions about your lifestyle.

Your doctor will be especially interested in your family's history of cardiac illness, your diet, your smoking and drinking history, your exercise habits, and your approach to stress management. Your answers will help him diagnose or eliminate heart disease as a source of your pain.

Your doctor may order diagnostic testing. The tests which diagnose heart disease include: a chest x-ray, an electrocardiogram (ECG), an exercise tolerance test, pharmacological stress testing, an echocardiogram, or cardiac catheterization.

If your doctor knows that your chest pain is due to noncardiac causes, he will not order additional cardiac testing.

What should I do if I experience new or unusual chest pain?
There are certain types of chest pain which are likely to be caused by cardiac disease. Sometimes chest pain may indicate that you are having a heart attack. If you experience any of the following symptoms, you should seek immediate medical attention:

• a dull ache, numbness or pressure;
• a crushing, squeezing, or choking sensation;
• a tight band around your chest;
• feeling as if an elephant is sitting on your chest;
• pain that spreads from your chest to your shoulders, neck, arms, back, abdomen, teeth or jaw;
• pain accompained by shortness of breath, irregular pulse, sweating, or dizziness.

If you are confused or uncertain about your symptoms, it is wise to seek prompt medical evaluation. It is better to pursue a false alarm than to ignore a potentially serious situation.

How is chest pain treated?
Treatment varies depending upon the source of the pain. Sometimes rest or over-the counter medications will relieve your symptoms. Consult with your physician to determine the best course of treatment.