Noncardiac chest pain

Klinika Gastroenterologii, Centralny Szpital Kliniczny Ministerstwa Obrony Narodowej, Wojskowy Instytut Medyczny. Kierownik Kliniki: prof. dr hab. n. med. Jerzy Gil
Adres do korespondencji: Klinika Gastroenterologii, Centralny Szpital Kliniczny Ministerstwa Obrony Narodowej,
Wojskowy Instytut Medyczny, ul. Szaserów 128, 00-909 Warszawa, tel.: 22 681 75 99
Praca finansowana ze środków własnych

Pediatr Med rodz Vol 9 Numer 1, p. 25–31
ABSTRACT

Chest pain is always a symptom that requires careful diagnosis, accurate collection of medical interviews with the patient and the medical examination. This is one of the most common symptoms, which causes the appearance of anxiety in patients and becomes the cause of the notification to the doctor or to the hospital. Chest pain is commonly attributed to heart disease. However the cardiovascular etiology of the above disorders is one of many others etiology. Chest pain, despite different etiology, may be similar in feature and location, as a result of similar nerve supply, anatomy and the location of various structures inside the chest. The source of chest pain may be all the structures inside the chest, except the lung-parenchyma, which doesn’t have the painful nerve endings. The basic element in the differential diagnosis of pain in this location is the exclusion of life-threatening conditions: acute coronary syndrome, aortic dissection, pulmonary embolism, and pneumothorax. A patient with a chest pain can both occur in the cardiologist and a gastroenterologist, but also in the family doctor, paediatrician,  pulmonologist, neurologist, surgeon, orthopaedist, rheumatologist, dermatologist and psychiatrist. This interdisciplinary nature of the problem led the authors to discuss this topic. In the study, we focused on describing the noncardiac chest pain and the use of modern methods of diagnosis, mostly in terms of the gastrointestinal causes. In this study, the authors didn’t analyse the cardiovascular aetiology of those diseases.

Keywords: chest pain, gastro-oesophageal reflux disease, oesophageal manometry, pH-metry of oesophagus, oesophageal motility disorders