Clinical Approach to Non-Cardiac Chest Pain

  • Donald O. Castell


What is the likelihood that recurring substernal chest pain might be related to an esophageal abnormality? There are a number of potential mechanisms for what I prefer to call unexplained chest pain because I respect the concept of an entity such as microvascular angina that may be a source of unrecognized heart disease, although not fixed coronary artery disease, in some of these patients. Esophageal etiologies such as GERD or spastic type abnormal contractions must be considered. Finally, we must not forget the interaction of the nervous system, particularly with syndromes such as visceral hyperalgesia.


Chest Pain Esophageal Motility Provocative Test Diffuse Esophageal Spasm Noncardiac Chest Pain 
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Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Donald O. Castell
    • 1
  1. 1.Department of MedicineGraduate HospitalPhiladelphiaUSA

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