Atypical chest pain refers to chest pain where a person does not experience the typical diagnostic characteristics of chest pain.

Typically, there are three characteristics that define chest pain. They include:

  • chest discomfort or pain in the center of the chest
  • pain that aggravates from stress or exertion
  • finding that nitrates or rest help to relieve symptoms

This article reviews what atypical chest pain may feel like, its possible causes, and when to see a doctor.

a person with chest pain is leaning over a kitchen counterShare on Pinterest
FG Trade/Getty Images

Experts generally define atypical chest pain as any pain that does not have the same characteristics as typical chest pain.

Typical chest pain presents as follows:

  • A person will have chest discomfort or pain in the center of their chest.
  • Stress or exertion aggravates the pain.
  • Nitrates or rest can relieve symptoms within a few minutes.

A doctor may diagnose a person with atypical chest pain if they only experience two of the three symptoms. This may indicate that a person does not have myocardial ischemia. This means that there is likely no full or partial blockage of blood flow to the heart.

Atypical chest pain may feel like a burning or stabbing feeling in the chest. It may resemble indigestion in some people.

A person may also feel:

  • a sense of discomfort or pressure in the chest
  • back pain or discomfort
  • pain in the upper abdomen

Atypical chest pain has several potential causes, which can include cardiac (heart) related causes and noncardiac causes. They may include:

Gastrointestinal tract-related causes

The gastrointestinal tract can cause atypical chest pain to occur. Typically, conditions that may affect the chest include gastroesophageal reflux disease (GERD) and gastritis.

GERD is a chronic medical condition where stomach contents flow back up into the esophagus. The reflux can cause heartburn, which a person feels in their chest.

Gastritis is inflammation in the stomach. It can cause discomfort or pain that occurs in the chest. It can be acute or chronic and has several potential underlying causes including drinking excessively and infections.

Musculoskeletal chest pain

Certain medical conditions and injuries can cause atypical chest pain to occur.

Costochondritis causes inflammation in the cartilage of the chest. It typically causes chest pain, which means a person will typically need to rule out other underlying causes of pain such as a heart attack.

Issues with the lungs

Less commonly, issues with the lungs can cause atypical chest pain to occur. Some possible causes include:

  • Lung cancer: Lung cancers start in the lungs or bronchi. As a tumor grows, it can cause a person to experience atypical chest pain. It is a leading cause of death and often occurs due to smoking.
  • Pneumonia: Pneumonia refers to several different bacteria, viruses, or fungi that infect the tissue of the lungs. It is a leading cause of death in the United States and can cause atypical chest pain and other symptoms.
  • Pulmonary embolism: A pulmonary embolism occurs when a blot clot blocks blood flow to part of the lung. It can cause several symptoms, including chest pain, to occur.

Cardiac related causes

Cardiac or heart-related conditions can also cause atypical chest pain to occur. Some possible underlying heart-related causes include:

  • Myocarditis: Myocarditis refers to inflammation of the heart that is often the result of an infection. Though most common in younger people, anyone may develop the condition.
  • Heart valve disease: This condition often affects older adults. Narrowing of the left ventricle during the release of blood into the aorta characterizes the condition. It can cause fatigue, chest pain, and other symptoms to occur.
  • Pericarditis: The pericardial sac surrounds the heart and helps to provide some protection to the organ. Pericarditis refers to inflammation that affects the sac. Experts consider it a common cause of chest pain, particularly in males.
  • Heart attack: Also known as myocardial infarction, a heart attack occurs when blood flow to the heart stops. It can cause atypical chest pain and other symptoms, such as fatigue, nausea, and pain in other body areas.

People who present with atypical chest pain may be more likely to have a cardiac cause, such as a heart attack/myocardial ischemia, in certain conditions, such as diabetes.

Chest pain is typically something a person should take seriously if they do not know the underlying cause. Heart-related atypical chest pain can be life threatening, particularly when it involves a heart attack.

Signs a person may be having a heart attack include:

  • chest pain or discomfort
  • shortness of breath
  • discomfort or pain in the shoulders or arms
  • feeling faint, weak, or light-headed
  • jaw, neck, or back pain

A person should call 911 if they experience symptoms that may signal a heart attack. The earlier treatment starts, the better a person’s chances of survival.

Atypical chest pain occurs when the symptoms do not match the diagnostic criteria of typical chest pain.

Several conditions can cause atypical chest pain including heart, lung, and gastrointestinal issues. Heart-related causes can be life threatening. A person should seek immediate medical attention if they experience signs of a heart attack, such as chest pain, nausea, or pain in the shoulders or arms.