Characteristics of major noncardiac causes of chest pain

Condition	Duration of pain	Character of pain
Gastroesophageal reflux	5 to 60 minutes	Visceral, substernal, worse with recumbency, no radiation, relief with food, antacids
Esophageal spasm	5 to 60 minutes	Visceral, spontaneous, substernal, associated with cold liquids, relief with nitroglycerin
Peptic ulcer	Hours	Visceral, burning, epigastric, relief with food, antacids, normal ECG
Biliary disease	Hours	Visceral, epigastric, interscapular colic, occurs after meals
Cervical disc	Variable	Superficial, positional, arm, neck
Musculoskeletal	Variable	Superficial, positional, worse with movement, local tenderness
Hyperventilation	2 to 3 minutes	Visceral, substernal, tachypneic, anxious
Thyroiditis	Persistent	Aggravated by swallowing, neck, throat tenderness

Excludes pain above the neck or below the umbilicus.

ECG: electrocardiogram.

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