Key result
Recurrent noncardiac chest pain has an excellent long-term prognosis, with management focusing on excluding coronary atherosclerosis, reassurance, acid suppression, and antidepressants.
Noncardiac chest pain requires exclusion of coronary atherosclerosis, followed by reassurance and targeted therapies like acid suppression or antidepressants, with an excellent long-term prognosis.
May inform reassurance after CAD exclusion; leaves open need for RCTs to refine therapies.
The pathogenesis of recurrent noncardiac chest pain remains an enigma. The literature suggests that it may be caused by a heightened state of visceral nociperception. Coronary atherosclerosis must first be excluded with a reasonable degree of certainty. The physician can then focus on reassuring the patient and continuing management, bearing in mind the caveat, first do no harm. Polypharmacy and hazardous procedures should be avoided. Aggressive acid suppression is helpful in patients with gastroesophageal reflux disease, and antidepressants have shown promise in otherwise unexplained cases of chest pain. Despite significant morbidity in patients with the disorder, the long-term prognosis is excellent.
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Anil Minocha (1996) conducted a review in Noncardiac chest pain. Recurrent noncardiac chest pain has an excellent long-term prognosis, with management focusing on excluding coronary atherosclerosis, reassurance, acid suppression, and antidepressants.
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