Clinical investigations from the RACP

Investigation and management of noncardiac chest pain

Clinical investigations from the RACP

Investigation and management of noncardiac chest pain

Geoff Hebbard, Claudia Gruebel

Abstract

Noncardiac chest pain is common and diagnosis can be difficult; however, in most cases patients can be reassured that the natural history is benign. Gastro-oesophageal reflux disease is the most common underlying cause; resolution of symptoms after treatment with a proton pump inhibitor may obviate the need for further investigations.

Key Points

  • Noncardiac chest pain (NCCP) is common and diagnosis can be difficult; however, in most cases the natural history is benign.
  • The most common underlying cause of NCCP is gastro-oesophageal reflux disease. Resolution of symptoms following treatment with a proton pump inhibitor (PPI) may obviate the need for further investigations.
  • If treatment with a PPI is not effective, other causes should be sought and treated.