Diminished quality of life in non-cardiac chest pain: A cause as much as an effect.

Non-cardiac chest pain (NCCP) is a condition that is increasingly being recognized as a significant driver of increased patient morbidity as well as health care costs via frequent utilization of health care services. While an exact definition of NCCP has not been outlined, one prevalent description is recurrent chest pain that is indistinguishable from ischemic heart pain after a reasonable workup has excluded a cardiac cause. NCCP is often attributed to esophageal conditions such as gastroesophageal reflux disease, non-erosive reflux disease,functional chest pain, and esophageal motility disorders. Uncertainty still exists surrounding its epidemiology and the totality of its inciting factors, but diminished patient quality of life is a characteristic of NCCP that has consistently been reported. The paper of Ortiz-Garrido et al. assesses quality of life in Mexican patients with NCCP and its relation to clinical characteristics and etiology. The study, conducted at a single health care center in Mexico, matched 33 patients with NCCP of presumed esophageal origin to 51 healthy controls with no history of chest pain or esophageal symptoms. The case patients all underwent esophagogastroduodenoscopy, 24-hour esophageal pH monitoring, and esophageal manometry to determine the etiology of their NCCP and were all surveyed to determine the characteristics of their symptoms. Forty-eight percent of the case patients were diagnosed with gastroesophageal reflux disease, 34%