Korean J Med.  2010 Jul;79(1):16-22.

The clinical characteristics of noncardiac chest pain and treatment response in non-erosive reflux disease (NERD)

• Choi TH
• Lee DH
• Jeong YJ
• Lee BH
• Hwang TJ
• Park YS
• Kim NY

Abstract

BACKGROUND/AIMS
Noncardiac chest pain (NCCP) is defined as recurring angina-like retrosternal chest pain of noncardiac origin. Gastroesophageal reflux disease (GERD) is by far the most common cause of NCCP. We evaluated the incidence of some esophageal abnormalities as a cause of NCCP and the treatment response to a proton pump inhibitor (PPI).
METHODS
Forty seven NCCP cases were selected from 184 cases who underwent 24-hour ambulatory pH monitoring or esophageal manometry. Patients were excluded if they had a history of gastrointestinal surgery, pancreatobiliary disorder, coronary artery disease, valvular heart disease, depression or tuberculosis. In this study, all GERD patients had non-erosive reflux disease (NERD).
RESULTS
Of the 47 NCCP cases, 30 (63.8%) were female and 17 (36.2%) were male. Only 7 (14.9%) cases had typical GERD symptoms such as acid regurgitation and heartburn. Of the 47 NCCP cases, 12 (25.5%) had GERD-related NCCP, and six (12.8%) had esophageal motility disorder. Of the 12 cases diagnosed as GERD-related NCCP, nine (75.0%) showed a satisfactory PPI response. The PPI was effective for GERD-related NCCP compared with non-GERD related NCCP (p=0.015).
CONCLUSIONS
About 40% of NERD patients with NCCP had an esophageal disorder including GERD and esophageal motility disorder. A PPI was effective for GERD-related NCCP.

Keyword

Noncardiac chest pain; Non-erosive reflux disease; Proton pump inhibitors

MeSH Terms

Chest Pain
Coronary Artery Disease
Depression
Esophageal Motility Disorders
Female
Gastroesophageal Reflux
Heart Valve Diseases
Heartburn
Humans
Hydrogen-Ion Concentration
Incidence
Male
Manometry
Proton Pump Inhibitors
Proton Pumps
Thorax
Tuberculosis
Proton Pump Inhibitors
Proton Pumps