Managing Pseudocardiac Angina: Symptoms, Causes, and Treatment Options

Pseudocardiac angina, also known as non-cardiac chest pain, mimics the symptoms of true angina, including chest tightness, pressure, discomfort, palpitations, and even irregular heartbeats. Despite its resemblance to cardiac-related chest pain, pseudocardiac angina is not caused by heart disease. Instead, it can stem from a variety of both cardiac-linked and non-cardiac conditions, making it essential to properly diagnose and treat the underlying cause.

Understanding the Cardiac-Linked Causes

Some cases of pseudocardiac angina are related to internal cardiac factors, particularly in women. For instance, women—especially those going through menopause—may experience symptoms due to hormonal changes and autonomic nervous system imbalances. These changes can lead to sensations similar to angina, even in the absence of coronary artery disease.

Treatment Approaches for Hormonal and Neurological Factors

For patients experiencing pseudocardiac angina linked to hormonal fluctuations, doctors often recommend B-vitamin supplements and medications that support circulation and nerve function. Stress management and emotional stability are also crucial. Patients are advised to avoid situations that cause emotional distress or anxiety, as these can exacerbate symptoms.

Non-Cardiac Conditions That Mimic Angina

Many cases of pseudocardiac angina are actually caused by issues unrelated to the heart. Common culprits include gastrointestinal disorders such as gastroesophageal reflux disease (GERD), chronic gastritis, and peptic ulcers. These conditions can produce chest pain that feels remarkably similar to angina, often leading to misdiagnosis if not carefully evaluated.

Other Contributing Factors

In addition to digestive problems, musculoskeletal conditions like costochondritis (inflammation of the rib cartilage), intercostal neuralgia, or previous chest injuries can also cause chest pain that resembles angina. A thorough medical evaluation is necessary to distinguish between true cardiac issues and these alternative causes.

Effective Management and Diagnosis

Proper diagnosis is key to managing pseudocardiac angina effectively. Healthcare providers may use a combination of electrocardiograms (ECGs), blood tests, and imaging studies to rule out heart disease. Once non-cardiac causes are identified, treatment can be tailored to address the specific condition—whether that involves acid reflux medication, anti-inflammatory drugs, or therapies targeting nerve-related pain.