can occur due to one of the following causes:
of cardiac muscles- most common cause commonly called angina pectoris
2. Gastro-esophageal reflux diseases (GERD): In GERD there is relfux of gastric contents into the esophagus
. This causes burning sensation and also pain in the chest region which can radiate to shoulders and back.
3. Dissection of aorta: Dissection of aorta is usually an emergency, however, when the dissection is mild or when in its initial stage it can cause just pain in the chest
4. Esophageal causes: Esophagitis
in the upper part of esophagus (besides GERD associated esophagitis) e.g. herpes
or cytomagalovirus associated esophagitis.
5. Musculoskeletal pain: This can be associated with muscle associated or bone related disease.
Of these causes pain originating from heart condition - ischemia and dissection of aorta are classically reported as severe debilitation pain often associated with breathing difficulty and sweating. If you do not have this classical symptoms it is less likely to be from heart ischemia (angina). However we do not rule out angina pain based on symptoms alone.
Considering you had stress tests, ECG and troponin
value as normal, if the pain characteristics hasn't changed from what it was few years ago (before tests), I would not include angina in my differentials now. But if the pain characteristics has changed, you will need to repeat the tests - stress test to assess the current status. Further a MRI of the chest region can also be done to know the status of blood vessels and muscloskeletal system.
Hope this answers your question. If you have more queries, I will be glad to answer.
Dr Shailja P Wahal