By far the most common cause of esophageal NCCP is gastroesophageal reflux disease also known as GERD or acid reflux. In addition to chest pain, patients may complain of heartburn and or regurgitation or chest pain alone may be due GERD. Eliminate non-cardiac chest pain. Or rather, eliminate the expression. Cumulative irritation over several years leads me to comment on the. Noncardiac chest pain: systematic review of the literature on prognosis Edwin Meresh, John Piletz, Angelos Halaris Department of Psychiatry.


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However, many patients with NCCP have psychiatric morbidity and poor quality of life.

GERD: Non-Cardiac Chest Pain Management and Treatment | Cleveland Clinic

Several questions remain about NCPP with respect to the psychopathology and pathophysiology of this condition. Whether NCCP patients have good or bad outcome requires careful risk stratification.


Movements used were thoracic rotation in both directions, in flexion and extension, and cervical flexion, extension, rotation and lateral flexion. In many of the patients dubbed mechanical, referred pain along an intercostal nerve or in non cardiac chest pain cervical nerve root distribution could be reproduced and confirmed as the presenting symptom.

Noncardiac chest pain: systematic review of the literature on prognosis

These movements could also cause pallor, sweating and dyspnoea. Non cardiac chest pain results were that 44 patients non cardiac chest pain clinically mechanical chest pain referred from cervical or thoracic spine or, in a few, clearly referred from a costo-chondral or chondro-sternal joint, and two of these patients had positive stress tests; 26 of the patients clinically had angina and five of them had negative exercise tests and went on to myocardial perfusion imaging.

Five patients clinically had oesophageal symptoms as suggested by exacerbation on lying flat, the presence of acid reflux and improvement with antacids or proton-pump inhibitors PPIs.


When non-cardiac chest pain is caused by a muscle problem, simple treatments, such as a heating pad, stretching exercises, or over-the-counter pain relievers like ibuprofen, can relieve the pain.

Non-cardiac chest pain non cardiac chest pain be due to stress, anxiety, or depression. A psychologist can help patients with these problems work through them so they do not cause chest pain.

Non-cardiac Chest Pain | ACG Patients

While chest pain can be a bona fide symptom of coronary artery disease CADnot infrequently, the origin of chest pain remains non cardiac chest pain even after thorough cardiovascular evaluations. NCCP is associated with exceedingly high health-care costs due to activity limitations for the patients, health-care utilization, repeated admissions to coronary care units, and further catheterizations.

Regardless of the etiology of the pain, NCCP patients suffer, and they experience poor psychological and quality-of-life outcomes. The question is how many of these patients eventually develop cardiovascular morbidity and mortality.

It has been shown that acute and chronic anxiety can be associated with sudden cardiac death and CAD. A large proportion of older women report levels of depressive symptoms that are significantly related to increased risk of CVD death non cardiac chest pain all-cause mortality, even after controlling for established CVD risk factors.

Eliminate non-cardiac chest pain

It is important to understand the long-term prognosis of NCCP so that these patients can be better treated to decrease suffering and cost. Non cardiac chest pain this article, we review the literature focusing on studies that address the prognosis of NCCP patients.

Objective To identify studies in relation to the long-term prognosis of NCCP patients including cardiovascular health risk and psychological well-being. Methods Search strategy Two sources of material for inclusion in the review were identified — electronic database and reference lists from the papers reviewed.

Noncardiac chest pain: systematic review of the literature on prognosi | RRCC

We used a multistep search process to identify published research reports related to NCCP. Anxiety and depression influence reports of pain and thus contribute to the pathophysiology of NCCP. Lantinga et al found that patients with NCCP had higher levels of neuroticism and psychiatric comorbidity before and after non cardiac chest pain catheterization than did patients with CAD.

This finding appears to have prognostic significance because these patients display less improvement in pain, more non cardiac chest pain pain episodes, greater social maladjustment, and more anxiety at 1-year follow-up than individuals with relatively low initial levels of psychosocial disturbances.

In a large epidemiological study from England, a significant relationship between NCCP and psychiatric disorders was demonstrated in young adults. Studies have been inconsistent when the frequency of panic disorder, anxiety, and depression were compared between NCCP patients and those with CAD.

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