What Is Atypical Chest Pain?

If an individual experiences chest pain that does not meet the criteria to be called as a classic anginal chest pain is termed as Atypical Chest Pain. The symptoms experienced in such cases may be both cardiac as well as non-cardiac related. An anginal chest pain is a squeezing or pressure like sensation in the chest that is felt generally when an individual does any strenuous activity. This symptom is the classic presenting feature of coronary artery disease, which is a cardiac condition caused due to decreased supply of oxygenated blood to the heart. If an individual experiences pain that cannot be considered as anginal then that individual is said to suffer from Atypical Chest Pain. As opposed to Typical Chest Pain which is brought on by exertion, an Atypical Chest Pain does not occur in the sternum and may radiate to other regions of the body as well.

What Can Cause Atypical Chest Pain?

In Atypical Chest Pain, an individual experiences symptoms that are quite similar to symptoms noted in respiratory, musculoskeletal or gastrointestinal diseases. The symptoms generally noted in Atypical Chest Pain are fatigue, sweating, dizziness, and breathing problems. Although chest pain is more often than not an indicator of a cardiac condition, it is also brought on by non-cardiac causes also like due to some musculoskeletal issues or due to some psychiatric condition. Some of the causes of Atypical Chest Pain are:

What Can Cause Atypical Chest Pain

Costochondritis: Costochondritis is a medical condition which quite commonly causes Atypical Chest Pain. This pain is often associated with painful or labored breathing. This condition is caused due to inflammation of costal cartilages which join the ribs and the sternum. The reason for this inflammation may be upper respiratory infections, repetitive strain injuries or a direct trauma to the chest. Intercostal strains are also quite common in those sportsmen who play tennis, squash, golf and the like where they have to frequently swing the arms.

Stress: Stress is one of the major causes of Atypical Chest Pain. Severe stress can lead to panic attacks that tend to cause chest pain along with increased sweating and dizziness. This chest tightness and pain occur when the chest muscles contract due to increased anxiety or stress.

Acid Reflux: Acid Reflux is also one of the major non-cardiac causes of Atypical Chest Pain. In this disease, there is a backflow of the contents of the stomach and stomach acids back into the esophagus. The root cause of this backflow is weakness of the esophageal sphincter muscle. This backflow of the contents of the stomach into the esophagus causes a burning sensation in the chest and is termed as heartburn. Some of the common factors which may lead to Acid reflux are eating too much spicy foods, caffeinated drinks, abusing alcohol.

Lung Problems: Certain abnormal lung condition can also cause Atypical Chest Pain. These abnormal conditions include pneumonia, pneumothorax, pulmonary embolism, and bronchitis. These conditions tend to cause chest pain, as these conditions cause persistent coughing which causes the lung muscles to contract causing tightness and pain.

What Is The Difference Between Typical Chest Pain And Atypical Chest Pain?

Typical Chest Pain is a pain that is caused in the chest area and is brought on by physical exertion or stress and improves with rest or by taking nitroglycerine.

Atypical Chest Pain is a pain which does not fit the criteria of a typical chest pain. This pain is not brought on by physical exertion and is felt under the breastbone. This pain may not be located at the same area but may radiate to other regions of the body as well.

What Are The Symptoms That Are Associated With Atypical Chest Pain?

Some of the symptoms that are associated with Atypical Chest Pain are:

Pain will be pleuritic and will be sharp and pulsating. The pain will involve the chest wall. The area will be tender to palpation. The pain will be positional and will appear to be inflammatory. The pain can occur at any time and duration is between 5 to 15 minutes. The pain may or may not be relieved with nitroglycerin. This pain is quite similar to the pain that an individual experiences due to musculoskeletal, respiratory or gastrointestinal problems. Along with this, there will be:

  • Excessive fatigue
  • Profuse sweating
  • Lightheadedness
  • Breathing difficulties.

How Is Atypical Chest Pain Treated?

If an individual experiences recurrent episodes of chest pain then it becomes imperative that the individual undergoes a thorough medical evaluation in order to determine the exact cause of the chest pain and whether the chest pain is cardiac or non-cardiac in origin. Based on the duration and intensity of the pain the physician will be able to determine whether the individual is experiencing Typical or an Atypical Chest Pain. If the physician determines that the symptoms the individual is having are those of Atypical Chest Pain then treatment will be based on the underlying medical condition causing the pain. If the pain is caused by costochondritis then the individual will be prescribed pain medications and NSAIDs to control the pain and inflammation.

In case if the pain is caused by Acid Reflux, then the physician may prescribe antacids to control the condition. If the pain is felt to be psychogenic in nature and due to panic attacks and anxiety, the individual may be referred to a psychiatrist or a psychologist for a thorough evaluation and to formulate a treatment plan to control stress and anxiety either by means of medications or by techniques like cognitive behavioral therapy.

In case if the pain is due to a cardiac cause like blocked arteries or due to coronary artery disease then the individual will be given medications to control the condition. Surgery may be required to control severe cases.

To summarize, it is quite difficult to distinguish between chest pain caused by cardiac causes and chest pain caused due to non-cardiac causes. Hence it is imperative that if an individual experiences severe chest pains frequently that he or she gets checked out thoroughly to find out the underlying cause of the pain and to get treated for the condition that is causing this Atypical Chest Pain.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: April 29, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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