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Rev Cardiovasc Med. 2005;6 Suppl 4:S32-9.

Noncardiac chest pain.

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  • 1Division of Gastroenterology, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.


The clinical approach to the patient with unexplained chest pain is complex, as the history does not clearly separate cardiac from noncardiac etiologies. After a careful work-up has excluded coronary artery disease, a systematic search for an esophageal etiology is the next step. Gastroesophageal reflux disease (GERD) is most commonly associated with noncardiac chest pain and should be the first diagnosis pursued. A therapeutic trial of antisecretory therapy with proton-pump inhibitors is the most efficient initial approach to diagnosis and therapy of GERD-related chest pain and can easily be instituted by a cardiologist familiar with the optimal use of proton-pump inhibitors.

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