title: Noncardiac chest pain: the role of the cardiologist--a national survey.
abstract: BACKGROUND
  The current assumption is that noncardiac chest pain (NCCP) patients diagnosed by a cardiologist are commonly referred to a gastroenterologist for further evaluation. Thus far, there are no studies that assess the clinical approach and referral patterns of cardiologists when evaluating subjects with NCCP.
  
  
  OBJECTIVE
  To determine the extent of involvement of cardiologists in the management of NCCP patients.
  
  
  METHODS
  Cardiologists were randomly selected from the American College of Cardiology national membership list and sent a 20-item questionnaire that included demographic information, characteristics of practice, preferences of diagnostic tests, referral patterns, and treatment plans.
  
  
  RESULTS
  A total of 246 (33%) cardiologists returned the questionnaire. A mean of 12.6% of patients were diagnosed with NCCP and 45.5% were treated by a cardiologist in the past 6 months. Of the NCCP patients that were referred, most ended up in the primary care physician clinic (45.9%) followed by gastroenterologist clinic (29.3%). Most cardiologists are either comfortable (35%) or very comfortable (43.1%) in diagnosing NCCP. Proton pump inhibitors (44.9%), lifestyle modifications (28.7%), and H2 blockers (11.8%) are the three most commonly used therapeutic modalities for NCCP.
  
  
  CONCLUSIONS
  Cardiologists manage about half of the diagnosed NCCP patients by themselves. Of those NCCP patients that are referred, cardiologists prefer to send them to a primary care physician rather than a gastroenterologist.
authors.affiliation: Neuro-Enteric Clinical Research Group, Section of Gastroenterology, Southern Arizona VA Health Care System, 3601 South Sixth Avenue, Tucson, AZ 85723, USA.
authors.forename: Wai-Man
authors.initials: WM
authors.lastname: Wong
authors.forename: Sara
authors.initials: S
authors.lastname: Risner-Adler
authors.forename: Joy
authors.initials: J
authors.lastname: Beeler
authors.forename: Sara
authors.initials: S
authors.lastname: Habib
authors.forename: Jimmy
authors.initials: J
authors.lastname: Bautista
authors.forename: Steven
authors.initials: S
authors.lastname: Goldman
authors.forename: Ronnie
authors.initials: R
authors.lastname: Fass
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology; D002637:Chest Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D005260:Female; D005762:Gastroenterology; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications / Q000175:diagnosis; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology