Non-Cardiac Chest Pain: A Review of Environmental Exposure-Associated Comorbidities and Biomarkers

Details

• Personal Author:
  Clementi E ; Crowley G ; Haider SH ; Kwon S ; Lam R ; Mikhail M ; Nolan A ; Ostrofsky D ; Talusan A ; Veerappan A
• Description:
  The prevalence of non-cardiac chest pain (NCCP) ranges from 13-33%. A majority of those presenting with a chief complaint of chest pain are found to have a diagnosis of NCCP. Aerodigestive diseases are a cause of NCCP, and billions of dollars are spent annually on the treatment of NCCP. Furthermore, NCCP can cause significant psychological stress. NCCP is commonly diagnosed when patients have chest pain despite a normal cardiac evaluation. The leading cause of NCCP is gastro-oesophageal reflux disease (GORD). GORD should be suspected in patients who report a history of acid regurgitation, cough, dysphagia, and bloating. Another common cause of NCCP is obstructive airway disease (OAD). A thorough history and review of the symptoms should be performed for those with suspected NCCP, especially because of the contributing end organs. It is known that environmental exposures can commonly cause GORD and OAD; however, NCCP has not been fully explored in the context of environmental exposure. Patients with a history of exposure to particulate matter can develop environmental-exposure-associated GORD and coexisting OAD. This narrative review aims to provide a practical overview of NCCP, its causes, their relation to environmental exposure, and associated biomarkers. The authors used a PubMed search that spanned 2003-2018 to accomplish this. Additionally, this review provides a broad overview of biomarkers of GORD-associated NCCP and OAD-associated NCCP due to environmental exposure. [Description provided by NIOSH]
• Subjects:
  Biomarkers Environmental Exposure Occupational Health Particulate Matter Risk Assessment Risk Factors Safety
• Keywords:
  Author Keywords: Biomarkers Digestive System Environmental Exposure Exposure Levels Gastro-oesophageal Reflux Gastroesophageal Reflux Disease GERD NCCP Non-cardiac Chest Pain OAD Obstructive Airway Disease Particulate Matter Particulates PM Psychological Stress Risk Factors

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• ISSN:
  2054-6203
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  103-112
• Volume:
  7
• Issue:
  1
• NIOSHTIC Number:
  nn:20054829
• Citation:
  EMJ Gastroenterol 2018 Dec; 7(1):103-112
• Contact Point Address:
  Anna Nolan, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York City, New York
• Email:
  anna.nolan@med.nyu.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  False
• Start Date:
  20170701
• Source Full Name:
  European Medical Journal, Gastroenterology
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:69e463451522705000ca69648eddc5b33dad5b653a3050b51701fe0f7dac64c17581a3e095ca62bdf6a0a3768604e4b355e79ffc6483ddd28e91de8c302438e3
• Download URL:
  https://stacks.cdc.gov/view/cdc/217250/cdc_217250_DS1.pdf
• File Type:
  [PDF - 208.46 KB ]