Preprint / Version 1

Differentiating Non-Cardiac Chest Pain from Cardiac-Related Chest Pain: Causes, Risk Factors, and Effective Healthcare Strategies


  • Janna Saini Polygence Student



cardiovascular health, healthcare, cardiac, chestpain, medical field


Non-cardiac chest pain (NCCP) is a medical condition that includes chest discomfort or pain unrelated to cardiac problems. This abstract explores the causes and risk factors associated with NCCP and talks about effective methods for healthcare professionals to differentiate it from cardiac-related chest pain.

The causes of NCCP have a large range of conditions, including gastroesophageal reflux disease (GERD), musculoskeletal issues, anxiety, and panic disorders. GERD, in particular, is a significant contributor to NCCP, where the reflux of gas content (usually from eating food) goes into the esophagus causing irritation and discomfort. Musculoskeletal conditions, such as costochondritis and chest wall muscle strain, can also cause chest pain unrelated to cardiac problems.

NCCP varies depending on the underlying circumstances of each person. GERD-related NCCP risk factors include obesity, dietary habits, and smoking. Musculoskeletal-related NCCP risk factors include physically being overworked, trauma, or poor posture. Anxiety and panic disorders can contribute to non-cardiac chest pain in individuals with heightened stress responses, leading to muscle tension and altered pain perception.

In conclusion, NCCP has various underlying causes and risk factors, with GERD and musculoskeletal issues being the most common contributors. Healthcare professionals should come up with a systematic approach to differentiate NCCP from cardiac-related chest pain, by using patient history, physical exams, and appropriate diagnostic tests. This can help to save resources and people's time, as well as help with targeted management, and reduced healthcare costs.


Pope, J. H., Aufderheide, T. P., Ruthazer, R., Woolard, R. H., Feldman, J. A., Beshansky,

J. R., ... & Griffith, J. L. (2000). Missed diagnoses of acute cardiac ischemia in the

emergency department. New England Journal of Medicine, 342(16), 1163-1170.

Swap, C. J., Nagurney, J. T., & Value, M. E. M. C. (2005). Value and limitations of chest

pain history in the evaluation of patients with suspected acute coronary syndromes.

JAMA, 294(20), 2623-2629.

Theodoropoulos, K. C., Houston, M. C., & Rizos, I. K. (2012). Coronary artery calcium

score and cardiovascular risk. The Open Cardiovascular Medicine Journal, 6(1), 24-29.

Hlatky, M. A., Pryor, D. B., Harrell Jr, F. E., Califf, R. M., Mark, D. B., Rosati, R. A., & Pitt,

B. (1984). Factors affecting sensitivity and specificity of exercise electrocardiography:

Multivariable analysis. The American journal of medicine, 77(1), 64-71.

Bösner, S., Haasenritter, J., Becker, A., Karatolios, K., Vaucher, P., Gencer, B., ... &

Donner-Banzhoff, N. (2010). Ruling out coronary artery disease in primary care:

development and validation of a simple prediction rule. Canadian Medical Association

Journal, 182(12), 1295-1300.

(1) Mayo Clinic. (2021). Coronary artery spasm. Retrieved from


(2) American Heart Association. (n.d.). Prinzmetal's angina (variant angina). Retrieved


Figure 1


(3) Cleveland Clinic. (2020). Gallbladder Disease. Retrieved from

(4) American College of Gastroenterology. (2021). Gallstones. Retrieved from

(5) Mayo Clinic. (2021). Pancreatitis. Retrieved from

Figure 2

Figure 3

(6) National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Peptic

Ulcers (Stomach Ulcers). Retrieved from


(7) MedlinePlus. (2021). Peptic Ulcer. Retrieved from

(8) National Heart, Lung, and Blood Institute. (2020). Arrhythmia. Retrieved from

(9) Harvard Health Publishing. (2020). Arrhythmias. Retrieved from

Figure 4

(10) American Academy of Orthopaedic Surgeons. (2021). Costochondritis. Retrieved


(11) National Health Service. (2019). Costochondritis. Retrieved from

(12) Cleveland Clinic. (2021). Costochondritis. Retrieved from

(13) National Organization for Rare Disorders. (2021). Cardiac Amyloidosis. Retrieved


(14) Cleveland Clinic. (2021). Cardiac Amyloidosis. Retrieved from

(15) American Lung Association. (2021). Pleurisy. Retrieved from

(16) National Heart, Lung, and Blood Institute. (2021). Pleurisy and Other Pleural

Disorders. Retrieved from

(17) American Heart Association. (2021). Hypertrophic Cardiomyopathy (HCM).

Retrieved from


(18) Mayo Clinic. (2021). Hypertrophic cardiomyopathy. Retrieved from