Thomas Frieling1. 1. Department of Gastroenterology, Hepatology, Infectiology, Neurogastroenterology, Hematology, Oncology, and Palliative Medicine, HELIOS-Clinic Krefeld, Krefeld, Germany.
Abstract
BACKGROUND: Non-cardiac chest pain (NCCP) is recurrent angina pectoris-like pain without evidence of coronary heart disease in conventional diagnostic evaluation. The prevalence of NCCP is up to 70% and may be detected (in this order) at all levels of the medical health care system (general practitioner, emergency department, chest pain unit, coronary care). Reduction of quality of life due to NCCP is comparable, and partially even higher, to that caused by cardiac chest pain. Reasons for psychological strain are symptom recurrence in approximately 50%, nonspecific diagnosis with resulting uncertainty, and insufficient integration of other medical disciplines in the diagnostic workup. METHODS AND RESULTS: The management of patients with chest pain has to be multidisciplinary because non-cardiac causes may be frequently encountered. Especially gastroenterological expertise is required since the cause of chest pain is gastroesophageal reflux disease (GERD) in 50-60%, hypercontractile esophageal motility disorders with nutcracker/jackhammer esophagus or diffuse esophageal spasm or achalasia in 15-18%, and other esophageal alterations (e.g., infectious esophageal inflammation, drug-induced ulcers, rings, webs, eosinophilic esophagitis) in 32-35%. CONCLUSION: This review highlights the importance of regular interdisciplinary ward rounds and management of chest pain units.
BACKGROUND: Non-cardiac chest pain (NCCP) is recurrent angina pectoris-like pain without evidence of coronary heart disease in conventional diagnostic evaluation. The prevalence of NCCP is up to 70% and may be detected (in this order) at all levels of the medical health care system (general practitioner, emergency department, chest pain unit, coronary care). Reduction of quality of life due to NCCP is comparable, and partially even higher, to that caused by cardiac chest pain. Reasons for psychological strain are symptom recurrence in approximately 50%, nonspecific diagnosis with resulting uncertainty, and insufficient integration of other medical disciplines in the diagnostic workup. METHODS AND RESULTS: The management of patients with chest pain has to be multidisciplinary because non-cardiac causes may be frequently encountered. Especially gastroenterological expertise is required since the cause of chest pain is gastroesophageal reflux disease (GERD) in 50-60%, hypercontractile esophageal motility disorders with nutcracker/jackhammer esophagus or diffuse esophageal spasm or achalasia in 15-18%, and other esophageal alterations (e.g., infectious esophageal inflammation, drug-induced ulcers, rings, webs, eosinophilic esophagitis) in 32-35%. CONCLUSION: This review highlights the importance of regular interdisciplinary ward rounds and management of chest pain units.
Authors: Wai-Man Wong; Sara Risner-Adler; Joy Beeler; Sara Habib; Jimmy Bautista; Steven Goldman; Ronnie Fass Journal: J Clin Gastroenterol Date: 2005 Nov-Dec Impact factor: 3.062
Authors: Raphael R Bruno; Norbert Donner-Banzhoff; Wolfgang Söllner; Thomas Frieling; Christian Müller; Michael Christ Journal: Dtsch Arztebl Int Date: 2015-11-06 Impact factor: 5.594
Authors: Amos Lal; Jamal Akhtar; Sangeetha Isaac; Ajay Kumar Mishra; Mohammad Saud Khan; Mohsen Noreldin; George M Abraham Journal: Respir Med Case Rep Date: 2018-10-09
Authors: Jinying Chen; Catarina I Kiefe; Marc Gagnier; Darleen Lessard; David McManus; Bo Wang; Thomas K Houston Journal: BMC Cardiovasc Disord Date: 2021-08-09 Impact factor: 2.174