November 01, 2011

Noncardiac chest pain

Heartburn, not heart attack

Noncardiac chest pain

When the gripping chest pain came on, you thought it was the "big one" and appropriately called for emergency care. But after extensive testing in the emergency room, your doctor told you your heart is fine.

About 30 percent of people undergoing heart-artery imaging (coronary angiography) for a suspected heart attack aren't having one. In subsequent testing, many cases of noncardiac chest pain are determined to be caused by a problem of the esophagus — the tube that connects your throat and stomach.

It's hard to imagine that esophagus pain could be confused with heart attack. But your esophagus and heart are in very close proximity, and they even have a similar nerve supply. Doctors often have no way to distinguish between esophagus pain and heart pain without testing. And since a heart attack is more deadly, the first task is usually to rule out heart trouble.

Still, even when heart trouble is ruled out, diagnosing the true problem can be tricky.

Heartburn

It's estimated that about 60 percent of people with noncardiac chest pain are found to have heartburn as the cause. Heartburn is often a symptom of gastroesophageal reflux disease (GERD), a condition in which digestive acid flows back (refluxes) from the stomach into the esophagus. It can cause a burning sensation that may be accompanied by a sour taste in your mouth.

However, chest pain experienced by those with heartburn or GERD is different from the typical burning sensation, which is why it may be mistaken...