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Noncardiac chest pain: diagnostic evaluation.

R Fass¹, S R Achem

¹Section of Gastroenterology, Department of Medicine, Southern Arizona VA Health Care System, Tucson, Arizona 85723-0001, USA. ronnie.fass@va.gov

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus

|July 23, 2011

Summary

Noncardiac chest pain (NCCP) affects millions yearly, presenting a diagnostic challenge due to its similarity to cardiac pain. Gastroenterologists investigate esophageal causes using various tests after cardiac and pulmonary issues are ruled out.

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Area of Science:

Gastroenterology
Internal Medicine

Background:

Noncardiac chest pain (NCCP) is a prevalent and complex clinical issue affecting a significant portion of the population.
NCCP poses a diagnostic challenge as its symptoms often mimic cardiac pain, necessitating extensive evaluations.
Patients with excluded cardiac and pulmonary causes are frequently referred for gastrointestinal assessment, particularly for esophageal origins.

Purpose of the Study:

To outline the diagnostic dilemma presented by noncardiac chest pain.
To highlight the common referral pathway to gastroenterology for esophageal investigations.
To present the array of diagnostic tools available for identifying the source of NCCP.

Main Methods:

Review of diagnostic approaches for noncardiac chest pain.
Identification of common tests used in gastroenterology for chest pain evaluation.
Discussion of the differential diagnosis process for chest pain.

Main Results:

Noncardiac chest pain is a common condition with symptoms often indistinguishable from cardiac pain.
Exclusion of cardiac and pulmonary etiologies leads to gastroenterological referral for esophageal evaluation.
A range of diagnostic tests, including pH monitoring, motility studies, endoscopy, and therapeutic trials, are available.

Conclusions:

Noncardiac chest pain requires a systematic diagnostic approach, often involving gastroenterologists.
Esophageal sources are a primary focus in the differential diagnosis of NCCP after cardiac causes are excluded.
The availability of multiple diagnostic tests aids clinicians in determining the origin of noncardiac chest pain.