Non Cardiac causes of Chest Pain

Not all chest pain is caused by damage to the heart. Although most people who have chest pain are likely to think of the heart as the first cause of the pain, there are numerous non cardiac causes of chest pain which need to be considered as well. Some of the non cardiac causes of chest pain can be quite simple and easy to take care of, while other causes can be just as deadly as damage to the heart itself.


One of the most common causes of chest pain not related to the heart is a condition known as costochondritis. Costochondritis is an inflammation of the cartilage located between the ribs. This inflammation can be due to an acute infection or trauma – but often the exact cause is not known. The pain associated with costochondritis often appears rapidly and can be quite intense. Because of this, it is commonly mistaken for a heart attack. The chest wall will become quite tender with costochondritis, which helps differentiate it from a heart attack.

Gastroesophageal Reflux

It is also possible to have chest pain from another common condition known as gastroesophageal reflux, or GERD. Reflux happens when the acid from the stomach flows backwards up into the esophagus, causing inflammation and damage to the inner lining of your esophagus. This happens more commonly in older people and people who eat a lot of spicy foods. Reflux and the associated pain is typically more common at night when a person is lying down.

Rib or Muscle Damage

If you suffer damage to the ribs or supporting muscles of the chest wall, you can experience significant pain. Ribs do an excellent job of protecting the organs in your chest, but they are able to be broken if enough force is applied to them. When they are broken, the resulting pain in the chest can be quite intense, especially when you move or twist your chest. Muscle tears or pulls to the supporting muscles of the chest wall can also cause chest pain.


Infection with the virus which causes a shingles infection can sometimes cause pain in the chest. This shingles virus infects the nerves in the skin covering the chest. During an outbreak of the infection, the infected nerves become irritated and can become quite painful. This can quite easily cause a pain in the chest that is sharp and localized to the area of the infection.

Let’s look at some of the more serious and potentially deadly causes of chest pain not related to the heart directly.


A pneumothorax is the presence of air in the space between the lung and the inner chest wall. There are several causes and types of pneumothorax. One of the more common types, called a spontaneous pneumothorax, involves a small rupture in the lining of the lung which allows air to leak in to the chest cavity. In addition, penetrating trauma to the chest can allow air to leak in from the outside. Many cases of pneumothorax are relatively mild and will resolve on their own. However some types, such as a tension pneumothorax, can be an acute medical emergency requiring immediate treatment. Because of the pressures being placed on the tissues surrounding the lung, most cases of pneumothorax will result in some degree of pain in the chest.

Pulmonary Embolism

An embolism is a medical term for anything which causes a blockage to your veins or arteries. A pulmonary embolism is most commonly caused by a clot of blood which forms in the deep veins of your legs and travels up through your heart in to the blood vessels which supply your lugs. This clot will obstruct the proper blood flow to the lungs. When this happens, blood is not able to obtain oxygen from your lungs. Pulmonary embolism is are typically associated with an extremely sharp and acute pain in the chest.

If they are large enough, pulmonary embolisms can be quite dangerous. They are a leading cause of death and disability, especially amongst hospitalized patients. Treatment for pulmonary embolisms must be initiated immediately in order to restore proper blood flow to the lungs, and prevent the death of the person affected.

Aortic Dissection

The aorta is the primary artery which leads out of the heart and begins the distribution of blood throughout your body. The aorta is a complex structure, which involves multiple layers of tissue and specialized muscles. When these tissues are damaged, it is possible for them to separate and rupture. This rupture is known as an aortic dissection, and it will allow blood to leak from the inside of the aorta in to the layers of the vessel itself. This causes and acute, tearing pain in the chest. Oftentimes this pain will radiate around to the back.

If an aortic dissection is not properly diagnosed and treated, it has an extremely high fatality rate. Over half of people with an acute aortic dissection which is untreated will die within 48 hours, and over 90% will die within one month. Even with prompt treatment, the mortality rate is quite high.

Chest pain must always be taken very seriously by a person and their doctor. Although many non cardiac causes of chest pain can be relatively simple and easy to take care of, there are many causes which can be quite deadly if they are not treated quickly and appropriately. If you have any chest pain, it is very important to see a doctor as soon as possible in order to determine the cause of the pain and initiate proper treatment.