Chest Pain: If It Is Not the Heart, What Is It?

Noncardiac chest pain is an angina-type discomfort without indication of ischemia. Diagnosis can be difficult because of its heterogeneous nature. Classification varies by specialty; gastroenterology uses the terminology gastroesophageal reflux disease related versus non-gastroesophageal re flux disease related. Other disciplines recognize noncardiac chest pain as having gastrointestinal, musculoskeletal, psychiatric, or pulmonary/other as underlying causes. Diagnostics yield a specific cause for effective treatment, which is aimed at the underlying cause, but it is not always possible. Some patients with noncardiac chest pain have comorbidities and ongoing pain that lead to decreased quality of life and continued health care use.