The key difference between cardiac and non-cardiac chest pain is that cardiac chest pain refers to discomfort or pressure in the chest due to inadequate blood flow to the heart, while non-cardiac chest pain refers to unrelated sharp sensations in the chest that originate outside the heart.
Chest pain is a pain or discomfort that arises anywhere between the upper abdomen and the neck. Different underlying causes can cause it. Depending on the cause, there are two main categories of chest pain. They are cardiac chest pain and non-cardiac chest pain. Cardiac chest pain is associated with conditions like angina pectoris, myocardial infarction, and coronary artery disease. In contrast, non-cardiac chest pain is associated with conditions that are not related to the heart, like gastroesophageal reflux diseases, indigestion, and pleural disorders. The pathophysiological reason for chest pain in these various conditions is that the heart, esophagus, lungs, and large blood vessels send their afferent nerve signals to the same thoracic autonomous ganglia.
CONTENTS
1. Overview and Key Difference
2. What is Cardiac Chest Pain
3. What is Non-cardiac Chest Pain
4. Similarities – Cardiac and Non-cardiac Chest Pain
5. Cardiac vs. Non-cardiac Chest Pain in Tabular Form
6. FAQ – Cardiac and Non-cardiac Chest Pain
7. Summary – Cardiac vs. Non-cardiac Chest Pain
What is Cardiac Chest Pain?
Cardiac chest pain, which is also known as angina, refers to pain or discomfort in the chest due to reduced blood flow to the heart muscles. Generally, it is commonly described as a pressure, tightness, or heaviness of the sternum area, which then reflects to the left arm, jaw, and neck. In most cases, the pain lasts for a few minutes and is relieved by rest or using nitroglycerin. Cardiac chest pain is often accompanied by shortness of breath, nausea, sweating, and dizziness. This is a condition requiring immediate medical attention. The risk factors for cardiac chest pain are physical activity, emotional stress, extreme cold and heat, heavy meals, drinking excessive alcohol, and cigarette smoking.
Cardiac chest pain can be diagnosed through physical symptoms evaluation, electrocardiogram (ECG), stress test, cardiac catheterization, cardiac MRI, and coronary CT scan. Furthermore, treatment options for cardiac chest pain may include a healthy lifestyle, taking prescribed medication such as nitroglycerin, beta-blockers, and calcium channel blockers, and managing related conditions such as high blood pressure, high cholesterol, diabetes, and overweight.
What is Non-cardiac Chest Pain?
Non-cardiac chest pain, which is also known as gas chest pain, refers to pain or discomfort in the chest mainly due to gastrointestinal causes, musculoskeletal disorders, and respiratory conditions. Usually, non-cardiac chest pain is described as a sharp, stabbing, or burning sensation in the chest. This is mostly recurrent and gets worse with stress or exertion. This condition is not life-threatening and is often temporary. It can be managed through lifestyle modifications. The symptoms of non-cardiac chest pain may include squeezing or burning substernal chest pain, which radiates to the back, neck, arms, and jaws, heartburn, acid reflux, sore throat, difficulty swallowing, abdominal bloating, stress, anxiety, and depression. The risk factors for non-cardiac chest pain are high BMI, smoking or tobacco use, NSAIDs, and anxiety.
Non-cardiac chest pain can be diagnosed through physical examination, electrocardiogram (EKG), blood test, pH study of the esophagus, esophageal motility test, upper endoscopy, and ultrasound. Furthermore, treatment options for non-cardiac chest pain may include proton pump inhibitors, pain blockers such as tricyclic antidepressants, and emotional and behavioral therapy (psychotherapy, cognitive behavioral therapy, biofeedback, and stress management techniques).
What are the Similarities Between Cardiac and Non-cardiac Chest Pain?
- Cardiac chest pain and non-cardiac chest pain can be felt in the same area of the chest.
- Lifestyle factors can influence both.
- They can manifest as acute or chronic episodes.
- Both chest pains can have a psychological impact on individuals.
- These types can be diagnosed through physical examination and imaging testing.
- Both types can be treated through specific medications
What is the Difference Between Cardiac and Non-Cardiac Chest Pain?
Cardiac chest pain arises from the heart and feels like pressure or tightness, while non-cardiac chest pain doesn’t involve the heart and can be a sharp or burning sensation. Thus, this is the key difference between cardiac and non-cardiac chest pain. Cardiac chest pain may respond to nitroglycerin, while non-cardiac chest pain won’t be significantly relieved by nitroglycerin. Understanding these differences helps healthcare professionals provide accurate diagnoses and appropriate care for individuals experiencing chest pain.
The infographic below presents the differences between cardiac and non-cardiac chest pain in tabular form for side-by-side comparison.
FAQ: Cardiac and Non-cardiac Chest Pain
What causes chest pain?
Chest pain can be caused due to different factors like heart issues, digestive problems, muscle strains, or respiratory issues.
How can we tell if chest pain is from the heart?
Chest pain from the heart often involves sensations like pressure, and tightness in the chest area radiating the left arm, jaw, and neck.
What is the role of nitroglycerin in treating chest pain?
Nitroglycerin is used to relieve cardiac chest pain by improving blood flow through blood vessel dilation. This may not have the same effect on non-cardiac chest pains.
Summary – Cardiac vs. Non-cardiac Chest Pain
In summary, cardiac chest pain stems from the heart, exhibiting pressure or squeezing sensations often radiating to the left arm, neck, and jaw, associated with heart conditions requiring immediate medical attention. Non-cardiac chest pain, originating outside the heart, manifests as sharp or burning sensations localized in the chest, with symptoms like bloating and difficulty swallowing. The main difference between cardiac and non-cardiac chest pain lies in their causes, response to nitroglycerin, and associated symptoms. Both types can have psychological impacts and may be acute or chronic.
Reference:
1. “Chest Pain: Cardiac vs Gastric Causes.” Medanta.org.
2. “Noncardiac Chest Pain.” An Overview | ScienceDirect Topics.
Image Courtesy:
1. “Close-up of a Man in Blue Polo Shirt with Hands on Chest” (CC0) via Pexels
2. “737 – chest pain” By Emergency Medicine Clinical Images and Videos (CC BY-NC-SA 2.0 DEED) via Flickr