Non cardiac causes of chest pain

Question 1

different non cardiac types

Answer 1

GI

Pulmonary

Musculoskeletal

Deramtologic

Question 2

Gastroesophageal

Answer 2

42% of chest pain where MI has been ruled out

Reflux oesophagitis:
– inflammation of the oesophageal mucosa secondary to gastroesophageal reflux disease
– often described as a burning sensation, heartburn or pyrosis

Oesophageal spasm:
– painful contractions within the muscular tube of the oesophagus
– often confused with ischaemic cardiac chest pain as its relieved by nitrates as well
– however, the chest pain of esophageal spasm is not related to exertion unlike ischaemic cardiac chest pain
– swallowing extremely hot or cold substances often precipitates spasm, which leads to episodes of chest pain

Oesophageal perforation:
– hole in the oesophagus, which allows saliva, liquid and food to spill into the thoracic cavity or abdomen
– sudden, severe, constant pain from the neck to the epigastrium that is worsened by swallowing
– neck swelling may be seen and subcutaneous emphysema evident

Gastritis:
– when the lining of your stomach becomes inflamed

Peptic ulcer disease:
– peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the stomach or small intestine

Question 3

Pulmonary

Answer 3

Pneumothorax

Pulmonary embolism

Pleuritis

Neoplasm

Bronchitis

Question 4

Musculoskeletal (chest wall)

Answer 4

28% of cases

Palpation of chest may reproduce the symptoms

Costochodritis (Tietze syndrome):
– inflammation of the costochondral junction

Rib fracture compression radiculopathy

Question 5

Dermatologic

Answer 5

Herpes zoster