Publication: How do we define non-cardiac chest pain?
Issued Date
2005-01-01
Resource Type
ISSN
14401746
08159319
08159319
Other identifier(s)
2-s2.0-33645912623
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Gastroenterology and Hepatology (Australia). Vol.20, No.SUPPL. 3 (2005)
Suggested Citation
Udom Kachintorn How do we define non-cardiac chest pain?. Journal of Gastroenterology and Hepatology (Australia). Vol.20, No.SUPPL. 3 (2005). doi:10.1111/j.1440-1746.2005.04164.x Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/17102
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Title
How do we define non-cardiac chest pain?
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Abstract
Noncardiac chest pain (NCCP) is a heterogeneous disorder associated with substantial health-care costs and resource utilization. NCCP is defined by recurrent episodes of substernal chest pain in patients lacking a cardiac cause after a comprehensive evaluation. The magnitude of the problem is quite high because of fear of serious or life-threatening heart diseases. Patients with chest pain who present for the first time to ambulatory care or to the emergency room, only 11% to 39% are ultimately diagnosed with coronary artery disease. The likely causes of NCCP are numerous and often overlap. Diagnosing NCCP is difficult because NCCP remains a diagnosis of exclusion that encompasses heterogeneous patient populations. First, cardiac ischemic must be excluded and coronary angiography remains the gold standard. Once cardiac causes have been ruled out, a diagnosis of NCCP is made. Mostly, the source for NCCP originates in essence from the esophagus. Gastroesophageal reflux disease (GERD) is the most common esophageal diseases present in patients with NCCP. An initial empiric trail of high-dose acid suppression is the most cost-effective measure in the management of these patients. When a diagnostic workup is chosen, it centers on upper gastrointestinal endoscopy, 24-hr esophageal pH monitoring and esophageal manometry. © 2005 Blackwell Publishing Asia Pty Ltd.
