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[Non-cardiac chest pain].
Gerson Ricardo de Souza Domingues1, Joaquim Prado P Moraes-Filho
1Departamento de Clínica Médica, Universidade Gama Filho, Rio de Janeiro, RJ. gersondomingues@grdgastro.com.br
Arquivos De Gastroenterologia
|November 18, 2009
Summary
Non-cardiac chest pain, often diagnosed after normal coronary angiograms, can stem from gastrointestinal, muscular, respiratory, or psychological issues. Treatment focuses on addressing the underlying cause, with proton pump inhibitors and antidepressants being key therapies.
Area of Science:
- Gastroenterology
- Cardiology
- Psychiatry
Context:
- Non-cardiac chest pain (NCCP) is prevalent, affecting 15-30% of patients with chest pain undergoing coronary angiography.
- NCCP significantly impacts patient quality of life and increases healthcare utilization.
Purpose:
- To review current literature on the causes, diagnosis, and treatment of non-cardiac chest pain.
- To highlight the importance of excluding cardiac disease in patients presenting with chest pain.
Summary:
- Selected 44 papers (original articles, reviews, guidelines, meta-analysis) from Medline, Cochrane Library, and LILACS published within the last 5 years.
- Identified gastrointestinal, muscular, respiratory, and psychological factors as common causes of NCCP.
- Emphasized drug therapy, particularly proton pump inhibitors and tricyclic antidepressants, as cornerstone treatments for NCCP, with specific considerations for achalasia.
Impact:
- Provides a comprehensive overview of NCCP, aiding clinicians in diagnosis and management.
- Suggests emerging therapies like botulinum toxin injections and hypnosis warrant further investigation.
- Aims to improve patient outcomes and reduce healthcare costs associated with undiagnosed or poorly managed chest pain.
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