Chest pain can be scary. It can make you wonder if you’re having a heart attack, and it can be one of the many common symptoms of acid reflux. GERD-related chest discomfort is often referred to as non-cardiac chest pain (NCCP), according to the American College of Gastroenterology (ACG).
The ACG explains that non-cardiac chest pain can mimic the pain of angina, a type of heart disease. Learning to distinguish the different types of chest pain can put your mind at ease and help you treat your acid reflux more effectively.
Cardiac chest pain and NCCP can both appear behind your breastbone, making the distinction between the two types of pain difficult to determine. Cardiac chest pain is more likely than reflux-related pain to radiate throughout your arms, back, shoulders, and neck. Chest pain stemming from GERD may affect your upper body in some cases, but is most often centered behind your sternum.
NCCP is usually accompanied by a burning behind your breastbone and may not be as present in the left arm as cardiac pain is. Esophageal spasms due to damage within the esophagus (either from acid reflux or other medical issues) can manifest themselves through pain in the throat and upper area of the chest as well.
You may be able to distinguish between types of chest pain by assessing what type of pain you’re feeling. Common adjectives used to describe pain associated with heart disease include:
- tightness, like a vice
Conversely, non-cardiac chest pain may feel sharp and tender.
Individuals diagnosed with GERD may experience temporary, intense
chest pain when taking a deep breath or coughing. This difference is key: the intensity level of cardiac pain remains unchanged when you breathe deeply. Reflux-related chest discomfort is less likely to feel like it’s originating from deep within your chest, and may seem like it’s closer to the surface of your skin.
To determine the cause of the discomfort, ask yourself if your chest pain changes in intensity or goes away completely when you change your body position. Muscle strains and GERD-based chest pain may feel better upon moving your body. The symptoms of acid reflux, including chest pain and heartburn, may ease considerably as you straighten your body to a sitting or standing position. Bending and lying down—particularly right after eating—can intensify GERD symptoms and discomfort.
Cardiac chest pain continues to hurt, regardless of the position of your body and can come and go throughout the day. Non-cardiac chest pain associated with digestion or a pulled muscle, for example, tends to be uncomfortable for an extended period of time before dissipating.
Assessing other symptoms that occur with chest pain can help you distinguish one form of pain from another. Pain caused by a cardiac issue can make you feel:
- short of breath
Non-cardiac, gastrointestinal causes of chest pain can include a variety of other symptoms, including:
- trouble swallowing
- burning in your throat, chest, or stomach
- sour taste in your mouth caused by regurgitation of acid
Diagnosis and Treatment
Chest pain should be taken seriously. Speak with your doctor about your symptoms. If you don’t have a prior history of GERD, your healthcare provider may perform an EKG or stress test to rule out heart disease as the underlying. Usually, a full medical history and diagnostic testing can uncover the reason for your chest pain and put you on the road to recovery.
Chest pain that accompanies frequent heartburn can be treated with proton pump inhibitor (PPI) medication, a type of drug that reduces acid production in your stomach. Your doctor also may recommend cutting out certain types of food, such as fried foods and citrus, which can trigger symptoms. A prolonged trial of PPI drugs can help relieve symptoms so that chest pain will no longer be a part of your life.