Non-cardiac chest pain

doi:10.1017/CBO9780511543579.206

Non-cardiac chest pain

from Medical topics

Published online by Cambridge University Press: 18 December 2014

Edited by

John Weinman and

Christopher Bass: Affiliation:
John Radcliffe Hospital
Susan Ayers: Affiliation:
University of Sussex
Andrew Baum: Affiliation:
University of Pittsburgh
Chris McManus: Affiliation:
St Mary's Hospital Medical School
Stanton Newman: Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston: Affiliation:
Vanderbilt University School of Nursing
John Weinman: Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West: Affiliation:
St George's Hospital Medical School, University of London

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Summary

Introduction

Non-cardiac chest pain (henceforth referred to as NCCP) has attracted an enormous amount of both clinical and research interest in the last five years. This has been accompanied by the publication of a number of major reviews by gastroenterologists (Botoman, 2002) as well as psychiatrists and psychologists (Thurston et al., 2001). More recently Accident and Emergency (A&E) physicians have also shown an interest in the topic (Goodacre et al., 2002), whereas cardiologists have been more concerned with rapid access chest pain clinics (Wood, 2001). What has provoked the resurgence of interest in this topic?

There are a number of possible explanations. First, the establishment of rapid access chest pain clinics in the UK has revealed that between one-half and three-quarters of patients attending these clinics do not have coronary heart disease. Second, high rates of patients with ‘undifferentiated’ or non-cardiac chest pain have been detected in chest pain observation units established both in the USA and the UK. Finally, there is evidence that these patients are not only a significant economic burden (Eslick et al., 2002) but also that certain interventions can reduce chest pain, consultation rates and disability (Mayou et al., 1997).

In this chapter the prevalence, diagnosis, pathophysiology, economic burden and management of patients with non-cardiac chest pain will be discussed. It is important to emphasize that the cause of NCCP is often multifactorial and that eliciting the interaction between each patients' symptom experience and interpretation is a key part of the clinical interview.

Type: Chapter
Information: Cambridge Handbook of Psychology, Health and Medicine , pp. 793 - 796

DOI: https://doi.org/10.1017/CBO9780511543579.206 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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Non-cardiac chest pain

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