Chronic Chest Pain

Abstract

Background. Chest pain is a symptom commonly reported by persons in the general population and represents a differential diagnostic challenge. Material and methods. The paper is based on a narrative review with a selective search of the literature in Medline for reviews and guidelines on the prevalence and treatment of non-malignant diseases with chronic chest pain in gastroenterology, gynecology and cardiology. Results. The prevalence and current treatment recommendations for the different forms of gastroesophageal reflux disease (GERD), erosive and non-erosive types and irritable esophagus, non-cardiac chest pain, refractory angina in coronary heart disease and postmastectomy nand poststernotomy syndromes are presented. In cases of failure of the established therapy of a single medical discipline, an interdisciplinary assessment including psychosocial issues is recommended. Evidence-based guidelines are available for the management of GERD and of refractory angina. Treatment of postmastectomy and poststernotomy syndromes is based on case reports and expert opinion. Conclusion. There is a need for controlled studies on the symptomatic treatment of pain in irritable esophagus, non-cardiac chest pain, postmastectomy and poststernotomy syndromes. © 2014 Springer-Verlag.