Document Detail


Approach to managing undiagnosed chest pain: could gastroesophageal reflux disease be the cause?
MedLine Citation:
PMID:  17872643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To highlight gastroesophageal reflux disease as a common cause of undiagnosed chest pain.
SOURCES OF INFORMATION: Diagnostic considerations are based on information in peer-reviewed articles retrieved from MEDLINE. Studies had to be in English and involve at least 30 subjects. Population-based studies had to have a sample size of at least 300 and a response rate of at least 60%. Thirty-seven relevant articles were found.
MAIN MESSAGE: Clinical management of patients presenting with diagnostically challenging chest pain starts with a careful search for coronary artery disease and other potentially life-threatening causes. Investigations must continue until the underlying disease is identified and symptoms have been effectively controlled. Ongoing symptoms of undiagnosed chest pain cause considerable suffering, impair quality of life, and add unnecessary costs to the health care system. In more than half the patients with undiagnosed chest pain, symptoms are caused by gastroesophageal disease. Empirical acid-suppressive therapy with a proton pump inhibitor can assist clinicians in identifying patients whose symptoms are acid-related.
CONCLUSION: Many patients with undiagnosed chest pain can be managed in primary care, minimizing the need for referrals and costly investigations.
Authors:
Nigel Flook; Peter Unge; Lars Agréus; Björn W Karlson; Staffan Nilsson
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Canadian family physician Médecin de famille canadien     Volume:  53     ISSN:  1715-5258     ISO Abbreviation:  Can Fam Physician     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-09-17     Completed Date:  2007-10-18     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  0120300     Medline TA:  Can Fam Physician     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  261-6     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, University ofAlberta, Edmonton,. nflook@shaw.ca
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MeSH Terms
Descriptor/Qualifier:
Antacids / therapeutic use
Chest Pain / diagnosis*,  drug therapy*,  etiology
Diagnosis, Differential
Female
Follow-Up Studies
Gastroesophageal Reflux / complications,  diagnosis*,  drug therapy*
Humans
Male
Middle Aged
Proton Pumps / antagonists & inhibitors*,  therapeutic use
Risk Assessment
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antacids; 0/Proton Pumps
Comments/Corrections
Comment In:
Can Fam Physician. 2007 Jul;53(7):1146-7; author reply 1147; discussion 1147   [PMID:  17872805 ]
Can Fam Physician. 2007 May;53(5):807-8; author reply 808   [PMID:  17872738 ]
Erratum In:
Can Fam Physician. 2007 Jul;53(7):1148

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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