Noncardiac chest pain: diagnostic evaluation

Dis Esophagus. 2012 Feb;25(2):89-101. doi: 10.1111/j.1442-2050.2011.01225.x. Epub 2011 Jul 21.

Abstract

Noncardiac chest pain (NCCP) is a common and challenging clinical problem. It is estimated that more than 70 million Americans (23% of the population) suffer from this condition yearly. Patients with NCCP represent a diagnostic dilemma. Their chest pain is often indistinguishable from cardiac pain leading to extensive and expensive evaluations. Once coronary artery disease and other cardiac and pulmonary sources of chest pain are excluded, patients are frequently referred to gastroenterologists to look primarily for esophageal sources of pain. A variety of diagnostic tests are available to the practicing clinician to identify the origin of pain, including ambulatory pH testing, esophageal motility, upper endoscopy, provocative testing and even therapeutic trials.

Publication types

  • Review

MeSH terms

  • Angina Pectoris / diagnosis*
  • Chest Pain / etiology*
  • Diagnosis, Differential
  • Endoscopy, Gastrointestinal
  • Esophagus / pathology*
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / drug therapy
  • Humans
  • Hydrogen-Ion Concentration
  • Proton Pump Inhibitors* / therapeutic use

Substances

  • Proton Pump Inhibitors