Non-cardiac chest pain: a real clinical problem

Non-cardiac chest pain is a frequent clinical problem. Between 10 and 50% of patients with anginal pain who are referred for arteriography are found to have normal coronary arteries. An oesophageal source of non-cardiac chest pain is reported in up to 60% of cases, most of which are attributable to gastro-oesophageal reflux disease. The exclusion of heart disease and the identification of an oesophageal origin of the pain may require an extensive work-up. The outcome in patients with non-cardiac chest pain is influenced by both the underlying diagnosis and the patient's perception of his or her symptom.