Non-cardiac Chest Pain Needs More Aggressive Management
By Lifesaver Education
Non-cardiac chest pain accounts for millions of visits to emergency rooms every day, and yet few people diagnosed with non-cardiac chest pain receive follow up to get to the bottom of their symptoms.
Common causes of non-cardiac chest pain include panic attacks, musculoskeletal pain, microvascular disease and gastroesophageal reflux (GERD). GERD accounts for up to 60% of cases of non-cardiac chest pain. GERD is the abnormal reflux of stomach acid from the stomach to the esophagus. Symptoms include heartburn (which can mimic the chest pain of a heart attack when severe), nausea and painful or difficult swallowing.
A study that was published in the Mayo Clinic Proceedings found that patients admitted to the ER with non-cardiac chest pain and later discovered to have GERD received little follow up testing. Only 15% of the patients studied went on to have a consult with a gastroenterologist. Survival rates for those patients in the study who were diagnosed with GERD were lower at 10 years and 20 years than in those patients who were given other explanations for their non-cardiac chest pain.
Study experts believe that people who suffer from GERD may also have risk factors for heart disease, and that these patients should be screened more closely for cardiac risk factors when they present to the ER. This is due to the fact that GERD and heart disease may share similar risk factors, such as obesity, smoking, diabetes and obstructive sleep apnea. In other words, they may be suffering from non-cardiac chest pain when they initially present to the ER, but their risk factors may put them at a higher risk to someday experience chest pain of cardiac origin. Therefore, these patients should be managed more aggressively than they usually are. To find out what to do in the event of chest pain, or for other Los Angeles CPR classes, visit Lifesaver Ed.
Source: Noncardiac Chest Pain May Warrant More Management: Study
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