Non‐cardiac chest pain: prevalence, risk factors, impact and consulting — a population‐based study

Abstract

SUMMARYBackground: Little is known about the prevalence and importance of non-cardiac chest pain in the general population. Aim: To evaluate the magnitude and impact of this condition. Methods: A validated self-report questionnaire was mailed to a sample of 1000 residents of Penrith, selected randomly from the electoral rolls. Symptoms, risk factors, psychological distress, quality of life and demographics were measured. Results: The response rate was 73% (n ¼ 672; mean age, 46 years; 52% female). Chest pain ever was reported by 39% of the population; 7% reported a history of myocardial infarction and 8% a history of

Postmenopausal Hormone Therapy as a Risk Factor for Gastroesophageal Reflux Symptoms Among Female Twins

“…Concerning GERD, there are many other underlying conditions, such as pulmonary, cardiac, malignant, musculoskeletal and psychological diseases that can produce GERD-like symptoms. 28 The concern of misclassification of reflux when using self-administered questionnaires based on symptoms only is allayed, however, by several studies showing that the symptoms used in our questionnaire are well validated as representing true reflux disease. 29, 30 However, any remaining misclassification of the outcome would rather dilute the observed associations and should not explain our positive findings.…”

“…The median age of onset of reflux symptoms was 45 years. Case participants were more overweight (BMI [25][26][27][28][29][30] or obese (BMI >30) than control participants (46.7% and 33.4% respectively). Ever use of estrogen was more common in the case group (30.6%) than in the control group (21.7%).…”

Depressive symptoms and healthcare utilization in patients with noncardiac chest pain compared to patients with ischemic heart disease

“…The first step included data collection using 3 screening questions (SQ-3). 28,29 Patients who answered positively to any of the 7 3 questions were considered having depressive symptoms and were therefore instructed to complete the Montgomery Åsberg Depression Rating Scale (MADRS). 30 Those who did not answer positively to any of the 3 questions did not complete the MADRS.…”

“…More than half of the patients consulting the emergency department due to chest pain are diagnosed with non-cardiac chest pain (NCCP) or unexplained chest pain. 2,[7][8][9][10][11][12] Non-cardiac chest pain is defined as angina-like pain with no evidence of ischemic heart disease (IHD) 2,8 and unexplained chest pain as pain that has not been explained by any obvious organic cause. 13 While there are well established guidelines for diagnosing and treating patients with IHD, [14][15][16] an international consensus approach to treat patients with NCCP is lacking.…”

“…Other studies have reported prevalence frequencies of depression in 20-50 % of patients with chest pain. 7,23,38,39 This is a much higher prevalence than in the general population where the depression rate lies between 10-15%. 40,41 No significant differences were found between patients with NCCP, AMI and AP regarding either prevalence or severity of the depressive symptoms.…”