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Non-cardiac chest pain

MedGen UID:
99198
•Concept ID:
C0476281
•
Sign or Symptom
Synonyms: Non-Cardiac Chest Pain; Noncardiac chest pain
SNOMED CT: Noncardiac chest pain (274668005); Non-cardiac chest pain (274668005)

Definition

Pain in the chest unrelated to a heart disorder. [from NCI]

Professional guidelines

PubMed

AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review.
Yadlapati R, Gyawali CP, Pandolfino JE; CGIT GERD Consensus Conference Participants
Clin Gastroenterol Hepatol 2022 May;20(5):984-994.e1. Epub 2022 Feb 2 doi: 10.1016/j.cgh.2022.01.025. PMID: 35123084Free PMC Article
Chicago Classification update (version 4.0): Technical review on diagnostic criteria for achalasia.
Khan A, Yadlapati R, Gonlachanvit S, Katzka DA, Park MI, Vaezi M, Vela M, Pandolfino J
Neurogastroenterol Motil 2021 Jul;33(7):e14182. Epub 2021 Jun 30 doi: 10.1111/nmo.14182. PMID: 34190376
Review article: the current treatment of non-cardiac chest pain.
George N, Abdallah J, Maradey-Romero C, Gerson L, Fass R
Aliment Pharmacol Ther 2016 Jan;43(2):213-39. Epub 2015 Nov 23 doi: 10.1111/apt.13458. PMID: 26592490

Recent clinical studies

Etiology

AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review.
Yadlapati R, Gyawali CP, Pandolfino JE; CGIT GERD Consensus Conference Participants
Clin Gastroenterol Hepatol 2022 May;20(5):984-994.e1. Epub 2022 Feb 2 doi: 10.1016/j.cgh.2022.01.025. PMID: 35123084Free PMC Article
Popular Remedies for Esophageal Symptoms: a Critical Appraisal.
Ahuja A, Ahuja NK
Curr Gastroenterol Rep 2019 Jul 10;21(8):39. doi: 10.1007/s11894-019-0707-4. PMID: 31289950
Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial.
Halliday BP, Wassall R, Lota AS, Khalique Z, Gregson J, Newsome S, Jackson R, Rahneva T, Wage R, Smith G, Venneri L, Tayal U, Auger D, Midwinter W, Whiffin N, Rajani R, Dungu JN, Pantazis A, Cook SA, Ware JS, Baksi AJ, Pennell DJ, Rosen SD, Cowie MR, Cleland JGF, Prasad SK
Lancet 2019 Jan 5;393(10166):61-73. Epub 2018 Nov 11 doi: 10.1016/S0140-6736(18)32484-X. PMID: 30429050Free PMC Article
Non-cardiac chest pain: assessment and management.
Chambers J, Bass C, Mayou R
Heart 1999 Dec;82(6):656-7. doi: 10.1136/hrt.82.6.656. PMID: 10573486Free PMC Article
Psychological aspects of non-cardiac chest pain.
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955

Diagnosis

Chest pain.
Rahman A
Aust J Gen Pract 2024 Jul;53(7):437-442. doi: 10.31128/AJGP-04-23-6810. PMID: 38957056
AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review.
Yadlapati R, Gyawali CP, Pandolfino JE; CGIT GERD Consensus Conference Participants
Clin Gastroenterol Hepatol 2022 May;20(5):984-994.e1. Epub 2022 Feb 2 doi: 10.1016/j.cgh.2022.01.025. PMID: 35123084Free PMC Article
Neurological Causes of Chest Pain.
Khan U, Robbins MS
Curr Pain Headache Rep 2021 Mar 24;25(5):32. doi: 10.1007/s11916-021-00944-5. PMID: 33760994
Non-cardiac chest pain: a 2018 update.
Durazzo M, Gargiulo G, Pellicano R
Minerva Cardioangiol 2018 Dec;66(6):770-783. Epub 2018 Apr 11 doi: 10.23736/S0026-4725.18.04681-9. PMID: 29642692
Unexplained (non-cardiac) chest pain.
Fox M, Forgacs I
Clin Med (Lond) 2006 Sep-Oct;6(5):445-9. doi: 10.7861/clinmedicine.6-5-445. PMID: 17080889Free PMC Article

Therapy

AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review.
Yadlapati R, Gyawali CP, Pandolfino JE; CGIT GERD Consensus Conference Participants
Clin Gastroenterol Hepatol 2022 May;20(5):984-994.e1. Epub 2022 Feb 2 doi: 10.1016/j.cgh.2022.01.025. PMID: 35123084Free PMC Article
Popular Remedies for Esophageal Symptoms: a Critical Appraisal.
Ahuja A, Ahuja NK
Curr Gastroenterol Rep 2019 Jul 10;21(8):39. doi: 10.1007/s11894-019-0707-4. PMID: 31289950
Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial.
Halliday BP, Wassall R, Lota AS, Khalique Z, Gregson J, Newsome S, Jackson R, Rahneva T, Wage R, Smith G, Venneri L, Tayal U, Auger D, Midwinter W, Whiffin N, Rajani R, Dungu JN, Pantazis A, Cook SA, Ware JS, Baksi AJ, Pennell DJ, Rosen SD, Cowie MR, Cleland JGF, Prasad SK
Lancet 2019 Jan 5;393(10166):61-73. Epub 2018 Nov 11 doi: 10.1016/S0140-6736(18)32484-X. PMID: 30429050Free PMC Article
Non-cardiac chest pain: a 2018 update.
Durazzo M, Gargiulo G, Pellicano R
Minerva Cardioangiol 2018 Dec;66(6):770-783. Epub 2018 Apr 11 doi: 10.23736/S0026-4725.18.04681-9. PMID: 29642692
New therapies for non-cardiac chest pain.
Maradey-Romero C, Fass R
Curr Gastroenterol Rep 2014;16(6):390. doi: 10.1007/s11894-014-0390-4. PMID: 24743955

Prognosis

Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial.
Halliday BP, Wassall R, Lota AS, Khalique Z, Gregson J, Newsome S, Jackson R, Rahneva T, Wage R, Smith G, Venneri L, Tayal U, Auger D, Midwinter W, Whiffin N, Rajani R, Dungu JN, Pantazis A, Cook SA, Ware JS, Baksi AJ, Pennell DJ, Rosen SD, Cowie MR, Cleland JGF, Prasad SK
Lancet 2019 Jan 5;393(10166):61-73. Epub 2018 Nov 11 doi: 10.1016/S0140-6736(18)32484-X. PMID: 30429050Free PMC Article
Non-cardiac Chest Pain and Anxiety: A Possible Link to Vitamin D and Calcium.
Alkhatatbeh MJ, Abdul-Razzak KK, Amara NA, Al-Jarrah M
J Clin Psychol Med Settings 2019 Jun;26(2):194-199. doi: 10.1007/s10880-018-9579-2. PMID: 30151664
Work Absenteeism and Presenteeism Loss in Patients With Non-Cardiac Chest Pain.
Félin-Germain A, Denis I, Turcotte S, Fleet R, Archambault P, Dionne CE, Foldes-Busque G
J Occup Environ Med 2018 Sep;60(9):781-786. doi: 10.1097/JOM.0000000000001363. PMID: 29851736
The prevalence and correlates of psychological outcomes in patients with acute non-cardiac chest pain: a systematic review.
Webster R, Norman P, Goodacre S, Thompson A
Emerg Med J 2012 Apr;29(4):267-73. Epub 2011 Oct 27 doi: 10.1136/emermed-2011-200526. PMID: 22034535
Psychological aspects of non-cardiac chest pain.
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955

Clinical prediction guides

Relationship between non-cardiac chest pain and internalizing problems in pre-school aged children.
Yoldaş T, Yoldaş TÇ, Beyazal M, Sayıcı Uİ, Örün UA
Cardiol Young 2020 Sep;30(9):1261-1265. Epub 2020 Jul 16 doi: 10.1017/S1047951120001948. PMID: 32669139
Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial.
Halliday BP, Wassall R, Lota AS, Khalique Z, Gregson J, Newsome S, Jackson R, Rahneva T, Wage R, Smith G, Venneri L, Tayal U, Auger D, Midwinter W, Whiffin N, Rajani R, Dungu JN, Pantazis A, Cook SA, Ware JS, Baksi AJ, Pennell DJ, Rosen SD, Cowie MR, Cleland JGF, Prasad SK
Lancet 2019 Jan 5;393(10166):61-73. Epub 2018 Nov 11 doi: 10.1016/S0140-6736(18)32484-X. PMID: 30429050Free PMC Article
Non-cardiac Chest Pain and Anxiety: A Possible Link to Vitamin D and Calcium.
Alkhatatbeh MJ, Abdul-Razzak KK, Amara NA, Al-Jarrah M
J Clin Psychol Med Settings 2019 Jun;26(2):194-199. doi: 10.1007/s10880-018-9579-2. PMID: 30151664
Work Absenteeism and Presenteeism Loss in Patients With Non-Cardiac Chest Pain.
Félin-Germain A, Denis I, Turcotte S, Fleet R, Archambault P, Dionne CE, Foldes-Busque G
J Occup Environ Med 2018 Sep;60(9):781-786. doi: 10.1097/JOM.0000000000001363. PMID: 29851736
Psychological aspects of non-cardiac chest pain.
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955

Recent systematic reviews

Evaluation of ICARUS Guidelines and Recommendations Not Supported by Randomized Controlled Trials.
Mohr C, Ciomperlik H, Dhanani N, Olavarria OA, Hannon C, Hope W, Roth S, Liang MK, Holihan JL
J Gastrointest Surg 2023 Feb;27(2):390-397. Epub 2023 Jan 17 doi: 10.1007/s11605-023-05590-3. PMID: 36650419
The prevalence and correlates of psychological outcomes in patients with acute non-cardiac chest pain: a systematic review.
Webster R, Norman P, Goodacre S, Thompson A
Emerg Med J 2012 Apr;29(4):267-73. Epub 2011 Oct 27 doi: 10.1136/emermed-2011-200526. PMID: 22034535
Beyond heartburn: a systematic review of the extra-oesophageal spectrum of reflux-induced disease.
Hungin AP, Raghunath AS, Wiklund I
Fam Pract 2005 Dec;22(6):591-603. Epub 2005 Jul 15 doi: 10.1093/fampra/cmi061. PMID: 16024554
Systematic review and modelling of the investigation of acute and chronic chest pain presenting in primary care.
Mant J, McManus RJ, Oakes RA, Delaney BC, Barton PM, Deeks JJ, Hammersley L, Davies RC, Davies MK, Hobbs FD
Health Technol Assess 2004 Feb;8(2):iii, 1-158. doi: 10.3310/hta8020. PMID: 14754562
A systematic review of the evidence for rapid access chest pain clinics.
McManus RJ, Mant J, Davies MK, Davis RC, Deeks JJ, Oakes RA, Hobbs FD
Int J Clin Pract 2002 Jan-Feb;56(1):29-33. PMID: 11833553

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