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Chest pain. Differentiating GIT from cardiac causes

P H Katelaris1

  • 1Gastroenterology Unit, University of Sydney Concord Hospital, Concord, NSW 2139. pkatelar@mail.usyd.edu.au

Australian Family Physician
|October 26, 2001
PubMed

Insights

Gastrointestinal issues frequently cause chest pain, mimicking cardiac problems. A thorough clinical history is crucial for diagnosing conditions like acid reflux and guiding appropriate treatment or investigations.

Area of Science:

  • Gastroenterology
  • Internal Medicine

Background:

  • Chest pain is a common symptom in primary care, necessitating consideration of cardiac causes despite non-cardiac origins being more frequent.
  • Gastrointestinal (GI) conditions, particularly esophageal disorders like reflux, hypersensitivity, and dysmotility, are common causes of non-cardiac chest pain.

Observation:

  • This review focuses on identifying primary gastrointestinal origins of acute chest pain.
  • Clinical history is paramount in differentiating causes and directing management strategies for chest pain.

Findings:

  • Gastroesophageal reflux disease (GERD) is a frequent cause of chest pain, often responsive to high-dose antisecretory therapy.
  • Diagnostic investigations such as endoscopy, ambulatory pH monitoring, barium swallow, and esophageal manometry are valuable when reflux is atypical or treatment-resistant.

Implications:

  • Accurate diagnosis of GI-related chest pain improves patient outcomes and reduces unnecessary cardiac investigations.
  • Understanding the spectrum of GI causes aids clinicians in selecting appropriate diagnostic pathways and therapeutic interventions for acute chest pain.
Abstract

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