An estimated 20 percent to 30 percent of patients who see a physician about chest pain actually have a problem in the esophagus (the tube joining the throat to the stomach) or upper stomach.

Another disorder that may feel like a heart attack is panic disorder, which can involve attacks of intense, gripping chest pain during which the heart beats strongly and rapidly. According to the National Institute of Mental Health, about three million Americans will experience panic disorder at some time during their lives. About 70 percent of patients who experience panic attacks can be successfully treated with medication.

Diagnostic Tests

If you experience unexplained chest pain, your doctor may want you to undergo some or all of the following tests:

Treadmill test.  

This is a test to determine how well the heart functions during exercise. If there is an abnormality, a cardiac catheterization, which allows a cardiologist to visually study the heart and arteries, may be done.

Upper-GI endoscopy.  

This is a test during which a lighted instrument is passed through the mouth and throat to the upper gastrointestinal tract so that a doctor can actually view its lining.

Esophageal motility studies.  

These involve insertion of a thin tube into the esophagus to measure pressure and detect function problems. During the test, the patient may receive medications to help trigger the symptoms.

Monitoring of acid levels.  

This involves the wearing of a monitoring device over a 24-hour period; the device measures acid levels in the esophagus.

What to Do If You Experience Chest Pain

If you have pain that is crushing and/or radiates from the center of the chest to the jaw, neck, or arms, you should go to the emergency room immediately, particularly if:

• it is the first time you have experienced the pain (or the pain is similar to pain experienced in a previous heart attack). You may be having a heart attack.
  
• the pain is different from that experienced in a previous heart attack, and it persists for more than five minutes. You may be having a mild heart attack.
  
• you are short of breath and have recently had an operation, injury, or illness that has kept you in bed. You may have a blood clot in your lung.
  

You should consult your physician immediately if:

• You are short of breath, have a cough, or have a temperature of 100 degrees F (38 degrees C) or above. You may have pneumonia.
  
• You are short of breath but have not had surgery and do not have a fever or cough. You may have a collapsed lung.
  
• You have coughed up grayish-yellow phlegm. You may have an infection of the airways in the lung.
  
• The pain in your chest burns and gets worse when you bend or lie down. You may have heartburn.
  
• The pain is on one side only. You may have a pulled muscle, a broken rib, or a nerve infection.
  
• You are unable to determine the nature of your pain from the symptoms listed above.