Beyond the heart: Noncardiac chest pain

Noncardiac chest pain (NCCP) is a diagnosis usually made after cardiac investigations have failed to demonstrate a specific diagnosis to explain either a single episode or recurrent episodes of chest pain.

The aim of this article is to describe the major causes and management of NCCP, with a focus on gastrointestinal conditions.

Despite its generally benign prognosis, NCCP is a cause of significant morbidity and can be responsible for a high personal cost and healthcare burden. NCCP is commonly associated with gastrointestinal conditions, including gastro-oesophageal reflux disease and oesophageal spasm. However, the differential diagnosis extends to musculoskeletal, neurological and psychiatric conditions, and the broad range of causes of the syndrome, which are not mutually exclusive, means that clinicians need to remain vigilant for changes in clinical pattern.