1.What is non-cardiogenic chest pain?
A: Non-cardiogenic chest pain refers to chest pain caused by lung disease, pleural disease, chest wall disease, intercostal nerve, esophageal disease, thoracic spinal cord disease, and upper abdominal disease, unrelated to coronary artery disease.
2.What is the manifestation of non-cardiogenic chest pain?
A: It mainly manifests as pain in the anterior chest area, chest region, axilla, occasionally radiating to the back of shoulder, intermittent or persistent, which can be squeezing pain, burning pain, pinprick-like, chest tightness and rise, without panic and telescopic breathing, and can be accompanied by dry cough and fever.
3.What are the common diseases of non-cardiogenic chest pain?
A: It includes pleural chest pain, chest wall chest pain, esophageal chest pain, cervical spine-origin chest pain, neurosis, etc. It is common for intercostal neuralgia, costochondritis, pleurisy, occult rib fracture and fracture deformity healing, reflux esophagitis, intrathoracic tumor invading pleura, spontaneous pneumothorax, lobar pneumonia, herpes zoster, cervical spondylosis, cardiac neurosis, biliary heart syndrome, etc.
4.What tests are needed for diagnosis?
A: Firstly, cardiogenic factors must be excluded, ECG, plate test, echocardiography, etc. X-ray examination can initially detect chest tumor, pneumonia, pneumothorax, rib fracture, CT and 3D imaging can confirm the diagnosis; MRI can detect inflammation and tumor of rib cartilage; gastroscopy can detect esophageal reflux and esophageal disease.
5.How does pleuritic chest pain occur?
A: Pleuritic chest pain is the most common type of non-cardiogenic chest pain, caused by inflammation, tumor, pneumothorax on the wall pleura pulling, stimulation of intercostal nerve and phrenic nerve, the pain is more accurately localized, aggravated by inspiration and relieved by exhalation, accompanied by severe dry cough and some fever. It is commonly caused by pleurisy, pleural tuberculosis, abscess, pneumothorax, lung abscess ulceration, lung cancer invading the wall pleura, and pleural mesothelioma.
6.How does chest wall pain occur and how does it manifest?
A: Chest wall pain is caused by trauma and inflammation, resulting in pathological changes of neuromusculoskeletal membrane, which is limited in scope, and deep breathing has no effect on the pain, while coughing and chest movement aggravate the pain.
7.How does esophageal origin chest pain occur and how does it manifest?
A: Esophageal and heart sensory nerve fibers are the same, so the stimulation of esophageal mucosa will produce angina-like chest pain, which is manifested as continuous burning pain behind the sternum or heartburn, and the pain can be increased when swallowing. Diseases that cause pain are common: reflux esophagitis, esophageal hiatus hernia, esophageal diverticulum, esophageal ulcer, Barrett’s esophagus, bile heart syndrome.
8.How does chest pain occur in cardiac neurosis? How does it manifest?
A: Cardiac neurosis is a syndrome with prominent manifestations of chest pain, fatigue and hypersensitivity, which is caused by the imbalance of plant nerves. The pain is dull, stabbing, or compressive pain, either in the left anterior chest or in the right anterior chest, not related to exertion, no abnormal heart examination, and nitroglycerin is ineffective.
9.How does psychogenic chest pain occur? How does it manifest?
A: It is a special type of neurosis, in addition to chest pain, the patient also has physical abnormalities: convulsions, headache, insomnia, anxiety, panic, depression, etc.
10. What should I pay attention to when I visit a doctor for chest pain?
A: You can find a cardiothoracic surgeon to rule out cardiac risk factors first, and then make detailed examination and analysis in order to get effective treatment.
11. How to treat pleuritic chest pain?
A: Pleurisy, pleural tuberculosis, abscess, pneumothorax and lung abscess can be drained by chest irrigation, lung cancer and pleural mesothelioma can be treated by tumor cryotherapy, chemotherapy and Chinese medicine can be used.
12. How to treat chest wall pain?
A: Intercostal nerve cryosurgery is feasible for rib fracture or fracture deformity healing, costochondritis and herpes zoster in stable stage, which has significant pain relief effect.
13. How to treat chest pain of esophageal origin?
A: Barrett’s esophagus, esophageal diverticulum, benign and malignant esophageal strictures need to be treated surgically; reflux esophagitis is treated with regular drug anti-reflux treatment, and anti-reflux surgery is performed with poor results.
14. What is the uniqueness of Chinese medicine in the treatment of non-cardiogenic chest pain?
A: The treatment of non-cardiogenic chest pain by western medicine is disappointing, while the effect of Chinese medicine is encouraging. We have developed a set of combined Chinese and Western medicine treatment plan according to the type of non-cardiogenic chest pain, which has achieved better efficacy.