Risk factors for non‐cardiac chest pain in the community

Abstract

SUMMARYBackground: Non-cardiac chest pain is a common and expensive condition. Risk factors for non-cardiac chest pain are poorly understood and lack description in the USA community. Aim: To explore risk factors and health-seeking behaviour in non-cardiac chest pain in a USA community. Methods: Olmsted County, MN subjects who reported at least monthly or severe chest pain in response to a validated questionnaire were compared with controls. All the Mayo Clinic medical records were reviewed; those with cardiac disease or relevant organic conditions were excluded. Results: Of 2118 eligible subjects, 1524 (72%) returned a questionnaire, 389 subjects (26%) reported any chest pain and 186 (12.2%) at least monthly or severe chest pain. Of these, 62 were excluded for a cardiac diagnosis or another organic cause. Thus, 124 subjects (9.1%, 95% CI: 7.6-10.8%) reported at least monthly or severe non-cardiac chest pain, of which 65 (52.4%) had frequent reflux symptoms. Independent risk factors for non-cardiac chest pain were obesity (OR 3.0, 95% CI:

Risk of Gastrointestinal Cancer in Patients with Unexplained Chest/Epigastric Pain and Normal Upper Endoscopy: A Danish 10-Year Follow-up Study

“…In our study, we intentionally excluded patients suspected of GERD (Fig. 1), and this is in contrast to the two studies mentioned, which reported a positive association between GERD and noncardiac chest pain [25,26]. However, it could be debated whether noncardiac chest pain patients with GERD symptoms are true noncardiac chest pain patients or should be defined as only GERD patients.…”

“…However, GERD has been suggested to be a risk factor for both noncardiac chest pain [25,26] and esophageal adenocarcinoma [27]. Therefore, some might have expected that UCEP patients had an increased risk of esophagus cancer.…”

Non-Cardiac Chest Pain

“…However, patients with NCCP are not generally different to patients with cardiac chest pain (CCP) with regard to demography and long-term follow-up [8,12,23,24]. Risk factors for NCCP are overweight (odds ratio (OR) 3.0, 95% confidence interval (CI) 1.64-5.50), reflux (OR 2.8, 95% CI 1.73-4.32), smoking (OR 2.0, 95% CI 1.27-3.18), aspirin (OR 1.5, 95% CI 1.00-2.31), non-steroidal anti-inflammatory drugs (OR 2.0, 95% CI 1.27-3.16), neuroticism (OR 1.14, 95% CI 1.08-1.21), and anxiety (OR 1.12, 95% CI 1.08-1.17) [24][25][26]. NCCP is found in all age groups, but the prevalence decreases with age.…”

Nichtkardialer Thoraxschmerz und gastroösophageale Refluxerkrankung

“…1). Bei bis zu 54% der Patienten mit nichtkardialem Thoraxschmerz konnte eine gastroösophageale Refluxerkrankung ("gastroesophageal reflux disease", GERD) als Ursache der Symptome nachgewiesen werden [21,40].…”