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Gastroenterology Research and Practice
Volume 2008, Article ID 708218, 4 pages
http://dx.doi.org/10.1155/2008/708218
Review Article

Evaluation and Management of Patients with Noncardiac Chest Pain

Neurogastroenterology Unit, Wythenshawe Hospital, Manchester M23 9LT, UK

Received 12 September 2008; Accepted 25 November 2008

Academic Editor: Ronnie Fass

Copyright © 2008 C. Shekhar and P. J. Whorwell. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Up to a third of patients undergoing coronary angiography for angina-like chest pain are found to have normal coronary arteries and a substantial proportion of these individuals continue to consult and even attend emergency departments. Initially, these patients are usually seen by cardiologists but with accumulating evidence that the pain might have a gastrointestinal origin, it may be more appropriate for them to be cared for by the gastroenterologist once a cardiological cause has been excluded. This review covers the assessment and management of this challenging condition, which includes a combination of education, reassurance, and pharmacotherapy. For the more refractory cases, behavioral treatments, such as cognitive behavioral therapy or hypnotherapy, may have to be considered.