Chest pain - if not a heart attack what other issue could it be.

Dear Ask The Doctor: Yesterday chest pain began as slight pressure on upper left breast area and stops right before armpit. Continued for hours and at times increased in intensity or radiated as a sharp pain from breast to armpit. Left arm became slightly numb, back and neck sore. Pain sometimes radiated to back. Pain level never surpassed a 4 on scale from 1-10. Went to ER. EKG, blood work and xray done. All were negative. Stayed over night for observation and continued blood work and portable monitor for heart was used and if any irregular beats occurred, it would have been reported. The following two blood tests returned negative. End result, never any additional signs of heart issue. All vital signs and temp were also normal. Have been released from hospital. The pain continues at same intensity levels and I will be calling a cardiologist tomorrow to make an appointment. My question is if it wasn't a heart attack, what else heart related could it be so that I may discuss that with the doctor.

Dear Yolanda: The chest pain that you are experiencing could be related to the heart . However there are many other causes which should also be ruled out. In your case I would especially rule out any breast tissue involvement leading to these signs. Also chest pain can be due to reflux disease, muscular in nature or even could be due to a costochondritis which is inflamation of the rib joints. You need to still have a stress test along with a few other blood tests to exactly find out the cause of this pain. I hope this helps and I wish you all the best.