title: Evaluation and management of patients with noncardiac chest pain.
abstract: Up to a third of patients undergoing coronary angiography for angina-like chest pain are found to have normal coronary arteries and a substantial proportion of these individuals continue to consult and even attend emergency departments. Initially, these patients are usually seen by cardiologists but with accumulating evidence that the pain might have a gastrointestinal origin, it may be more appropriate for them to be cared for by the gastroenterologist once a cardiological cause has been excluded. This review covers the assessment and management of this challenging condition, which includes a combination of education, reassurance, and pharmacotherapy. For the more refractory cases, behavioral treatments, such as cognitive behavioral therapy or hypnotherapy, may have to be considered.
authors.affiliation: Neurogastroenterology Unit, Wythenshawe Hospital, Manchester M23 9LT, UK.
authors.forename: C
authors.initials: C
authors.lastname: Shekhar
authors.forename: P J
authors.initials: PJ
authors.lastname: Whorwell