Surreal illustration of non-cardiac chest pain and anxiety

Chest Pain Without the Panic: Understanding and Managing Non-Cardiac Causes

Rhea Morgan in Health & Wellness August 2025 • 4 min read.

"Is it anxiety or something else? Discover how to distinguish non-cardiac chest pain from heart issues and effective strategies to manage it."

Chest pain is a common complaint, and while many immediately fear a heart attack, the reality is that a significant portion of chest pain originates from non-cardiac causes. This type of pain, known as non-cardiac chest pain (NCCP), can be unsettling, but understanding its causes and management strategies can bring reassurance and improve your quality of life.

NCCP is often linked to conditions like anxiety, panic disorders, and heightened stress levels. While the physical sensation is very real, the underlying cause isn't a problem with the heart itself. Studies show a strong connection between NCCP and psychological factors, highlighting the importance of addressing both physical and emotional well-being.

This article explores the prevalence of NCCP, its connection to anxiety, and practical steps you can take to manage the symptoms and regain control over your health.

Decoding Non-Cardiac Chest Pain: More Than Just a Heart Issue

Surreal illustration of non-cardiac chest pain and anxiety

NCCP is a diagnosis given when chest pain isn't caused by heart-related problems like angina or heart disease. Instead, it can stem from a variety of factors:

Anxiety and Panic Disorders: Anxiety can manifest physically, leading to chest tightness and pain. Panic attacks, with their sudden surge of fear, can mimic heart attack symptoms. The autonomic symptoms of anxiety are also features of NCCP, which may explain why higher levels of anxiety have been detected among individuals with NCCP.

Muscle Strain: Injury or overuse of chest muscles can cause localized pain.
Esophageal Issues: Acid reflux, heartburn, or esophageal spasms can trigger chest discomfort.
Costochondritis: Inflammation of the cartilage connecting ribs to the breastbone.
Stress and Emotional Factors: Heightened stress, depression, and emotional distress can all contribute to NCCP.

The connection between NCCP and anxiety is particularly noteworthy. Research consistently demonstrates a strong link between the two. The autonomic symptoms of anxiety are also features of NCCP, which may explain why higher levels of anxiety have been detected among individuals with NCCP. Anxiety can heighten pain perception and amplify physical symptoms, leading to a cycle of worry and discomfort. Up to 50% of NCCP patients remain worried they have a serious condition and continue to needlessly use cardiac services despite reassurance from physicians. Psychological difficulties are much less inclined to be resolved in NCCP compared with actual cardiac diagnosis.

Taking Control: Steps to Manage Non-Cardiac Chest Pain

If you experience frequent chest pain, it's essential to consult a doctor to rule out any underlying heart conditions. Once NCCP is diagnosed, a combination of lifestyle changes and therapies can help you manage symptoms and improve your overall well-being. While there are things that can be done, the association between NCCP and clinical anxiety warrants further exploration, more specifically in relation to the prevalence of anxiety among this patient population, and the development of appropriate and timely psychological interventions. Governments are increasingly recognizing the long term economic and social costs of high prevalence disorders including anxiety and panic disorder.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1186/s12913-017-2493-8, Alternate LINK

Title: The Prevalence Of Non-Cardiac Chest Pain (Nccp) Using Emergency Department (Ed) Data: A Northern Ireland Based Study

Subject: Health Policy

Journal: BMC Health Services Research

Publisher: Springer Science and Business Media LLC

Authors: Orla Mcdevitt-Petrovic, Karen Kirby, Mark Shevlin

Published: 2017-08-09

Everything You Need To Know

What exactly is Non-Cardiac Chest Pain (NCCP)?

Non-cardiac chest pain (NCCP) is chest pain that is not caused by heart-related issues such as angina or heart disease. Instead, NCCP can arise from various factors, including anxiety, panic disorders, muscle strain, esophageal issues like acid reflux, costochondritis (inflammation of cartilage connecting ribs to the breastbone), and heightened stress or emotional distress.

How are anxiety and panic disorders related to Non-Cardiac Chest Pain (NCCP)?

Anxiety and panic disorders are strongly linked to non-cardiac chest pain (NCCP). Anxiety can manifest physically, causing chest tightness and pain. Panic attacks can mimic heart attack symptoms due to a sudden surge of fear. Studies have detected higher levels of anxiety among individuals with NCCP. The autonomic symptoms of anxiety are also features of NCCP, which may explain why higher levels of anxiety have been detected among individuals with NCCP.

Besides anxiety, are there other potential causes of Non-Cardiac Chest Pain (NCCP)?

Yes, several factors can contribute to non-cardiac chest pain (NCCP). These include muscle strain in the chest area, esophageal problems like acid reflux or spasms, inflammation of the cartilage connecting ribs to the breastbone (costochondritis), and psychological factors like heightened stress, depression, and emotional distress. Each of these issues can independently trigger chest pain that is not related to the heart.

What are the steps to take in order to manage Non-Cardiac Chest Pain (NCCP)?

To manage non-cardiac chest pain (NCCP), it is essential to consult a doctor to rule out any underlying heart conditions. Once NCCP is diagnosed, management involves a combination of lifestyle changes and therapies. Future exploration should assess the association between NCCP and clinical anxiety warrants further exploration, more specifically in relation to the prevalence of anxiety among this patient population, and the development of appropriate and timely psychological interventions.

Why is it important to consider the role of anxiety when dealing with Non-Cardiac Chest Pain (NCCP), and what are the implications?

The link between anxiety and non-cardiac chest pain (NCCP) highlights the importance of addressing both physical and emotional well-being. Anxiety can heighten pain perception and amplify physical symptoms, leading to a cycle of worry and discomfort. Psychological difficulties are much less inclined to be resolved in NCCP compared with actual cardiac diagnosis. Government recognize the long term economic and social costs of high prevalence disorders including anxiety and panic disorder.