Many health conditions can cause chest pain. Healthcare professionals may use the term nonanginal chest pain to refer to chest pain in people without heart disease.

Nonanginal chest pain, which doctors may also call noncardiac chest pain, refers to pain a person without heart disease may feel behind the breast bone. The pain may feel similar to angina, but it occurs due to different causes.

Chest pain accounts for more than 6.5 million emergency room visits annually in the United States. Many people recognize it can be a symptom of a heart attack.

However, according to 2020 research from Europe, around 83% of those with chest pain and discharged from the ER had noncardiac chest pain. This type of pain often results from issues with the esophagus, lungs, or other causes.

This article discusses what nonanginal chest pain may feel like, its potential causes, and when to speak with a doctor.

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Nonanginal chest pain may feel like pressure or squeezing pain behind the breast bone that may extend to the neck, back, or left arm. A person may also experience other symptoms such as heartburn or regurgitation alongside the chest pain.

People may notice it after eating or drinking, and it may last a few seconds to many hours.

Read about stable angina.

There are many possible causes of chest pain other than heart-related issues. Other organs or body parts in the chest can also cause chest pain.

Gastroesophageal reflux disease (GERD) and other gastrointestinal issues

GERD is a chronic condition where a person’s stomach contents flow back to their esophagus.

Researchers suggest that it may be the most common cause of nonanginal pain, present in 50–60% of cases.

In these cases, nonanginal pain may feel similar to a heart attack because the heart and the esophagus are next to each other, and the same nerves travel through them.

Other possible esophageal and gastrointestinal causes of nonanginal pain may include:

Learn about the differences between heartburn and heart attack.

Musculoskeletal problems

Musculoskeletal problems, which may be due to muscle or bone injury in the chest wall, may also cause nonanginal pain. These problems may include:

Respiratory conditions

The lungs are close to the heart inside the chest cavity. Pulmonary problems, or issues with the lungs, may also lead to nonanginal chest pain. These problems may include:

Neurological conditions

Neurological conditions, such as nerve compression, may also lead to chest pain.

Thoracic radiculopathy, or nerve compression in the midback region, may radiate to the chest and cause a “band-like” burning or shooting chest pain.

Healthcare professionals may use the term intercostal neuralgia to refer to any painful condition affecting the intercostal nerves. It may cause sharp, burning, radiating, or stabbing pain along its distribution in the chest, abdomen, or ribs.

Shingles is an infection due to the reactivation of the varicella-zoster virus. It often affects the nerves and may cause chest pain as well as a painful rash on the chest.

Psychiatric conditions

Some individuals with nonanginal chest pain also have existing psychiatric conditions, including:

Additionally, some people with nonanginal chest pain may be living with heart-focused anxiety. Healthcare professionals may define this as an increased fear, avoidance, or vigilance of cardiovascular symptoms.

Learn more about why anxiety causes heart palpitations.

If a person experiences pressure-like chest pain or discomfort in the left or center of the chest that lasts more than a few minutes or goes away and returns, they may be experiencing a heart attack.

Other major symptoms of a heart attack may include:

People should call 911 immediately if they think they may be experiencing a heart attack.

GERD often causes nonanginal chest pain. However, people experiencing chest pain should speak with a healthcare professional who can diagnose the cause of the pain.

Doctors may recommend an upper gastrointestinal endoscopy to rule out other conditions if a person does not respond to GERD treatment or has the following symptoms:

Nonanginal chest pain is a common symptom of many conditions, ranging from gastrointestinal problems to psychiatric conditions. It may feel like a pressure or squeezing pain behind the breast bone.

People should speak with a healthcare professional to find out what may be causing their chest pain. A person should call 911 if they think they may be experiencing a heart attack.