Table of ContentsView AllTable of ContentsWhat Is a Peptic Ulcer?Symptoms of Chest Pain With Peptic UlcersCauses of Chest Pain With Peptic UlcersPeptic Ulcer vs AnginaTreatment Options
Table of ContentsView All
View All
Table of Contents
What Is a Peptic Ulcer?
Symptoms of Chest Pain With Peptic Ulcers
Causes of Chest Pain With Peptic Ulcers
Peptic Ulcer vs Angina
Treatment Options
Peptic ulcer diseaseis a common medical condition that can sometimes produce symptoms similar to those ofanginaor aheart attack. In fact, it is not uncommon for someone with acutepeptic ulcer symptomsto call 911 thinking that they’re in the middle of a cardiac emergency.
The cause of this is not well-understood, but it is thought that multiple factors contribute to noncardiac chest pain (NCCP) in people with peptic ulcers. This includes altered nerve signals and violent contractions of theesophagus(feeding tube) due to the backflow of stomach acid.
This article explains what peptic ulcer disease is and how it can lead to symptoms of NCCP. It also helps you tell the difference between acute peptic ulcer symptoms and those of angina or a heart attack.
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Peptic ulcers occur when the mucus that protects the lining of the stomach decreases or the production of stomach acid increases.
The primary cause of peptic ulcers is an infection with a bacteria known asHelicobacter pylori (H. pylori). The overuse ofnonsteroidal anti-inflammatory drugs (NSAIDs)like Aleve (naproxen) can also lead to peptic ulcers.
Causes and Risk Factors of Peptic Ulcer Disease
Typically, the pain from peptic ulcer disease is perceived as a sharp or stinging pain in the pit of the stomach but can sometimes cause noncardiac chest pain.
NCCP is defined as recurring chest pain—typically behind your breast bone (sternum)—that is not related to your heart. It is not only associated with peptic ulcers but also withgastroesophageal reflux disease (GERD). Extreme stress and anxiety attacks can also bring on NCCP.
NCCP easily mimics thesymptoms of angina, causing chest pain just behind the sternum or, in some cases, on the right or left side of the chest. The pain can also radiate to your neck, left arm, or back. There may also be rapid, pounding heartbeats as well aspalpitations(skipped heartbeats).
In their totality, these symptoms can easily be mistaken for a heart attack.
The cause of NCCP is not entirely clear, and it is likely a combination of physiological and psychological responses that contributes to the onset of angina-like chest pain.
What is known is that acid reflux (common with peptic ulcers and GERD) can cause the esophagus to spasm wildly. People with long-standing reflux appear to be at greater risk and often have a hypersensitive response to the backflow of stomach acid.
Studies suggest that persistent reflux alters nerve signals from the esophagus to thedorsal spinal root, one of the two main nerve roots of the spinal cord. The altered signals can amplify the sensation of pain in a way that is easily mistaken for angina.
It can causereferred painin which pain radiates to other parts of the body, such as the neck, back, and left arm.
These sensations can be intensified if you think you’re having a heart attack. During moments of extreme anxiety, the body will release a stress hormone known ascortisolthat causes your heart rate to increase dramatically.
Peptic Ulcer vs. Angina
The check pain is usually sharp, burning, or stinging.
Pain starts after eating or drinking.
Pain worsens with lying down.
Pain eases with antacids.
There is more chest pressure, heaviness, or tightness.
Pain happens suddenly or with exertion.
Pain worsens with exercise.
Pain does not ease with antacids.
Nevertheless, it may be important to do confirmatory tests to confirm the diagnosis.
Endoscopy(an examination of the upper digestive tract with a special flexible scope) is the favored method of diagnosis of peptic ulcer disease, especially in people who have evidence of bleeding or other severe symptoms.
Testing for the presence ofHelicobacter pylorimay also be helpful. X-rays of the upper digestive system may also be recommended.
If your healthcare provider is concerned about the possibility of angina, astress testmay be helpful in differentiating the conditions.
How a Heart Attack Is Diagnosed
Treatment
If a peptic ulcer is the cause of NCCP, the appropriate treatment will almost invariably reduce the risk of future episodes.
Treatment options include:
In rare cases, surgery may be considered if an ulcer fails to heal.
Peptic Ulcer Disease Treatment
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Durazzo M, Garguilo G, Pellicano R.Non-cardiac chest pain: a 2018 update.Minerva Cardioangiol.2018 Dec;66(6):770-83. doi:10.23736/S0026-4725.18.04681-9American College of Gastroenterology.Peptic ulcer disease.Frieling T.Non-cardiac chest pain.Visc Med.2018 Apr;34(2):92–6. doi:10.1159/000486440
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Durazzo M, Garguilo G, Pellicano R.Non-cardiac chest pain: a 2018 update.Minerva Cardioangiol.2018 Dec;66(6):770-83. doi:10.23736/S0026-4725.18.04681-9American College of Gastroenterology.Peptic ulcer disease.Frieling T.Non-cardiac chest pain.Visc Med.2018 Apr;34(2):92–6. doi:10.1159/000486440
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Durazzo M, Garguilo G, Pellicano R.Non-cardiac chest pain: a 2018 update.Minerva Cardioangiol.2018 Dec;66(6):770-83. doi:10.23736/S0026-4725.18.04681-9American College of Gastroenterology.Peptic ulcer disease.Frieling T.Non-cardiac chest pain.Visc Med.2018 Apr;34(2):92–6. doi:10.1159/000486440
Durazzo M, Garguilo G, Pellicano R.Non-cardiac chest pain: a 2018 update.Minerva Cardioangiol.2018 Dec;66(6):770-83. doi:10.23736/S0026-4725.18.04681-9
American College of Gastroenterology.Peptic ulcer disease.
Frieling T.Non-cardiac chest pain.Visc Med.2018 Apr;34(2):92–6. doi:10.1159/000486440
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