ATYPICAL CHEST PAIN OR NON- CARDIAC CHEST PAIN

Do you have:

1. Dull aching or sharp pain over chest area, localized over one part of chest.

2. Continuous pain throughout the day or increases with deep breathing or movement (forward or backward bending).

3. Pain NOT related to breathing difficulty, sweating, or increases with exertion or walking (ANGINA or Cardiac pain).

Chest pain is considered synonymous to heart attack or angina, and is very frightening for patients. But in most cases, Heart attack or Myocardial infarction is ruled out by Cardiologist opinion and normal investigations (ECG, 2D-Echo, Cardiac troponins and angiography). In such cases, where cardiac cause has been ruled, it is difficult to find the cause of such ATYPICAL or NON-CARDIAC chest pain. ©drsanjeevspainclinic/p>

Few causes:

a. Gastritis or GERD (Gastrointestinal reflux disease): It is the one of the most common cause of atypical chest pain. It is caused by reflux of gastric contents into food pipe or esophagus, causing pain over middle of chest. The pain is mostly burning in nature, which increases after intake of meals.

b. Costochondritis or Tietze's syndrome: It is swelling or inflammation of front end of ribs or junction of ribs with sternum. There is pin-pointed or localised pain over front end of ribs, which increases with deep breathing.©drsanjeevspainclinic

3c. Myofascial pain syndrome or Muscle Trigger points: Often in cases of long-standing cough or poor posture, patients may develop sustained localised muscle spasms or Trigger points in chest muscles. They cause Dull aching pain in chest, which may increase or decrease spontaneously with change in posture.

d. Lung related causes e.g Pulmonary embolism, COPD, Pneumonia,etc. can also produce chest pain, but it is associated cough, breathing difficulties, fever, etc.

e. Miscellaneous e.g. Anxiety or Panic attacks

Treatment depends upon diagnosis and severity of disease. ©drsanjeevspainclinic.

- Anti-inflammatory, muscle relaxants, anta-acids help in reducing pain.

- Local injection over costo-chondral junction under US guidance is given in cases of Costo-chondritis. In severe cases, Intercostal nerve RFA is also done.

- US guided Trigger point injection followed by exercise therapy & posture correction is advised in cases of Myofascial pain syndrome over chest.

- Spinal or thoracic cage manipulation also helps in some cases.