Noncardiac chest pain: systematic review of the literature on prognosis

Meresh, Edwin; Piletz, John E.; Halaris, Angelos

doi:10.2147/rrcc.s155441

Cited by 6 publications

(11 citation statements)

References 70 publications

(66 reference statements)

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“…On the other hand, disrupted HPA axis, as well as hypersecretion of cortisol in depression, is supported by some studies; therefore, the HPA axis plays a pivotal role in depression and accompanying pain [ 10 , 30 ]. There has been evidence for a low threshold of pain in depressed patients, and patients with NCCP also tend to exaggerate their pain, so the association of depression and NCCP has an added effect on reports of pain intensity [ 1 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Chest pain is a common patient complaint in cardiac emergency departments [ 1 , 2 ]. Up to 60% of these cases receive a non-cardiac diagnosis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Non-cardiac chest pain (NCCP) is defined as recurrent angina-like chest pain with no evidence of heart problems after medical examinations which drives patients to follow medical consultations and imposes a lot of costs on the patients and the health care system [ 1 - 3 ]. The annual financial burden of NCCP is more than double that of acute myocardial infarction and angina pectoris [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to financial burden and comparable to cardiac disease, NCCP negatively influences the quality of life and everyday life such as interruption of daily activities and occupational disability [ 5 , 6 ]. Several studies have supported the relationship between NCCP and psychological impairment such as depression, anxiety, and somatization [ 1 , 5 ]. It seems that type D personality in these patients is common, which is associated with the occurrence of psychological disorders and increases their risk of depression; however, few studies have considered this relationship [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…

Chest pain is a common patient complaint in cardiac emergency departments [1,2]. Up to 60% of these cases re-ceive a non-cardiac diagnosis [2].Non-cardiac chest pain (NCCP) is defined as recurrent angina-like chest pain with no evidence of heart problems after medical examinations which drives patients to follow

…”

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confidence: 99%

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Determinants of depression in non-cardiac chest pain patients: a cross sectional study

et al. 2021

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Background Non-cardiac chest pain (NCCP) is a common patient complaint imposing great costs on the healthcare system. It is associated with psychological factors such as depression. The aim of the present study is determining depression predictors in NCCP patients. Methods The participants of this cross-sectional study were 361 NCCP patients. Patients filled out questionnaires concerning their sociodemographic, lifestyle, and clinical factors (severity of pain, type D personality, somatization, cardiac anxiety, fear of body sensations, and depression). Results Based on multiple ordinal logistic regression, lack of physical activity (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.09-2.87), sleep quality (OR, 2.98; 95% CI, 1.15-7.69), being a smoker (OR, 1.33; 95% CI, 2.41-4.03), present pain intensity (OR, 1.08; 95% CI, 1.05-1.11), type D personality (OR, 2.43; 95% CI, 1.47-4.03), and somatization (OR, 1.22; 95% CI, 1.15-1.3) were significant predictors of depression in NCCP patients. Additionally, multiple linear regression showed that being unmarried (β = 1.51, P = 0.008), lack of physical activity (β = 1.22, P = 0.015), sleep quality (β = 2.26, P = 0.022), present pain intensity (β = 0.07, P = 0.045), type D personality (β = 1.87, P < 0.001), somatization (β = 0.45, P < 0.001), and fear of bodily sensation (β = 0.04, P = 0.032) increased significantly depression scores in NCCP patients. Conclusions Physicians should consider the predictors of depression in NCCP patients which can lead to receiving effective psychological consultations and reducing the costs and ineffectual referrals to medical centers.

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Section: Discussionmentioning

confidence: 99%

“…Chest pain is a common patient complaint in cardiac emergency departments [ 1 , 2 ]. Up to 60% of these cases receive a non-cardiac diagnosis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…

…”

mentioning

confidence: 99%

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Determinants of depression in non-cardiac chest pain patients: a cross sectional study

et al. 2021

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Cervical Radiculopathy as a Hidden Cause of Angina: Cervicogenic Angina

Chu

2022

J Med Cases

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Patients presenting with chest pain to the emergency department constitute a diagnostic challenge as 77% of the patients' symptoms are not cardiac. Diagnostic uncertainty is a pervasive issue in primary care. A 56-year-old man presented with non-traumatic chest pain and chronic neck pain for 2 years, as well as numbness in his right third and fourth fingers for 6 months. It was not associated with palpitation, orthopnea or pedal edema. Except for hyperglycemia, no abnormal findings were found in diagnostic tests. At that time, he was being treated for type 2 diabetes using glucose-lowering drugs in order to lower his blood glucose and lessen his risk of heart disease. The cause of his chest pain remained unknown. Following a second opinion from an orthopedist, the patient was diagnosed with cervical radiculopathy and was treated with analgesics and physical therapy. Because the treatments had only provided temporary pain relief for the previous 6 months, he sought chiropractic care for pain relief. The patient's vital signs were stable and within normal limits during the assessment. A restricted neck movement, a positive Spurling test, and hypoesthesia in the right C7 dermatome were seen. Cervical radiographs revealed degenerative spondylosis with right C5/C6 neuroforaminal stenoses and bilateral C6/C7 neuroforaminal stenoses. A provisional diagnosis of cervical spondylotic radiculopathy associated with cervicogenic angina (CA) was made. Chiropractic procedures, including cervical manipulation, instrumented soft tissue mobilization, and motorized intermittent neck traction, were performed two to three times per week. After 3 months, the patient reported that the chest pain, neck pain, and radicular symptoms had completely resolved. Repeated radiographs taken during the 11th month followup revealed a comparable improvement in the increased spacing of the restricted neuroforamina, which could signify a beneficial alteration related to cervical function retrieval. CA is an angina-like chest pain caused by cervical spine disorders. This study adds to our understanding of the biomechanical impact of cervical radiculopathy on chest pain, which has largely been overlooked during diagnostic workups. Once cervical radiculopathy has been identified, CA symptoms can be eased by alleviating the noxious input stemming from the pinched nerve roots.

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Noncardiac Esophageal Chest Pain -A Comprehensive Review

Negru

Dumitraşcu

2022

Internal Medicine

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Background and aim. Noncardiac chest pain (NCCP) is a medical condition described as acute, recurrent, or chronic chest pain, that is difficult to distinguish from ischemic heart pain, when the cardiac source has been excluded. Noncardiac chest pain represents a challenging clinical situation in gastroenterology practice, requiring sometimes a high amount of clinical investigation for a specific diagnostic. In some cases, the etiology is represented by esophageal diseases. This review aims to present the updated knowledge of the esophageal origin of NCCP. Methods. A search was performed in the main databases containing medical publications. The following search terms were used: noncardiac chest pain, esophageal chest pain (ECP), pathophysiology, noncardiac chest pain etiology, gastroesophageal reflux disease (GERD), motility esophagus disorders, functional chest pain. Observational studies were included. Studies that described only cardiac chest pain were excluded. Results. Noncardiac chest pain requires precise recognition of signs, symptoms and diagnostic testing in clinical practice. Due to financial constraints on subsequent care, an accurate algorithm based on clinical noncardiac chest pain guidelines should be followed. Esophageal chest pain represents a challenging diagnosis. Conclusions. Noncardiac chest pain is a prevalent and alarming symptom. Esophageal chest pain etiology should be considered once a cardiac source has been excluded.

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Noncardiac chest pain: systematic review of the literature on prognosis

Cited by 6 publications

References 70 publications

Determinants of depression in non-cardiac chest pain patients: a cross sectional study

Determinants of depression in non-cardiac chest pain patients: a cross sectional study

Cervical Radiculopathy as a Hidden Cause of Angina: Cervicogenic Angina

Noncardiac Esophageal Chest Pain -A Comprehensive Review

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