Effective treatment of chest pain: A Synthesis of Findings from 16 Studies

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Original Abstract of the Article

Major Research Findings

Chest pain can be caused by a variety of factors other than the heart, including the digestive system (such as the esophagus and stomach), muscles and joints, and psychological factors. Non-cardiac chest pain (NCCP) is often difficult to diagnose and treat, as the cause may be unknown. This can lead to significant psychological distress and anxiety for patients. 6

Studies have investigated various treatment approaches for NCCP, including medication, psychotherapy, and exercise therapy. 10 , 12 , 13 , 16 , 2 , 11 , 14 , 3 , 4 , 7 ,

Specific treatments include medications to reduce stomach acid (proton pump inhibitors), drugs to improve digestive movement, medications to relieve mental anxiety and tension (antidepressants), and cognitive behavioral therapy. 10 , 12 , 16 , 2 , 11 , 14 , 3 , 4 ,

These treatments are expected to alleviate symptoms and improve quality of life. 12 , 13 , 16 , 2 , 14 , 3 ,

Treatment Summary

The treatment for non-cardiac chest pain depends on the underlying cause. 10

If the cause is gastroesophageal reflux disease (GERD), proton pump inhibitors are effective. 10 , 14

If the cause is esophageal motility disorder, medications to improve digestive movement are used. 10

If the cause is primarily psychological, antidepressants and cognitive behavioral therapy can be effective. 12 , 16 , 2 , 14 , 3 ,

If the cause is muscular or skeletal, exercise therapy or manual therapy can be effective. 11

Benefits and Risks

Benefits Summary

Treatment for non-cardiac chest pain can be expected to alleviate symptoms and improve quality of life. 12 , 13 , 16 , 2 , 14 , 3 ,

Risks Summary

Medication can have side effects. 10 , 12

Comparison of Studies

Similarities

Many studies have shown that treatments such as medication and psychotherapy are effective for non-cardiac chest pain. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

Differences

The effectiveness of treatment and specific treatments vary between studies. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

Consistency and Contradictions in the Results

Some studies found that medication was effective, while others did not. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

Cautions for Applying Findings to Everyday Life

Treatment for non-cardiac chest pain varies depending on the patient's condition. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

It's essential to consult a doctor to determine the appropriate treatment. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

Limitations of Current Research

There is still a lack of research on treatments for non-cardiac chest pain. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

More research is needed. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

Future Research Directions

The development of more effective treatments for non-cardiac chest pain is highly anticipated. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

Conclusion

Non-cardiac chest pain can be difficult to diagnose and treat, as the cause is often unknown. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

However, appropriate treatment can alleviate symptoms and improve quality of life. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

If you experience chest pain, it's important to consult a doctor promptly. 10 , 12 , 16 , 2 , 14 , 3 , 4 ,

Treatment List

Proton pump inhibitors, Drugs to improve digestive movement, Antidepressants, Cognitive behavioral therapy, Exercise therapy, Manual therapy

Literature analysis of 16 papers
Positive Content
15
Neutral Content
0
Negative Content
1
Article Type
9
5
6
7
16
1.

Psychological treatment for atypical non-cardiac chest pain: a controlled evaluation.

Author: KlimesI, MayouR A, PearceM J, ColesL, FaggJ R

Improved daily life
Reduced chest pain
Reduced distress

This study investigated the effectiveness of cognitive-behavioral therapy (CBT) in 31 patients with chest pain that was not caused by heart problems. Patients who received CBT experienced significant reductions in chest pain, limitations in daily life, physical symptoms, distress, and mental health issues compared to a control group who received no treatment. These improvements were maintained at follow-up. The study concludes that CBT is an effective treatment for non-cardiac chest pain and can significantly improve quality of life.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Group psychological treatment for chest pain with normal coronary arteries.

Author: PottsS G, LewinR, FoxK A, JohnstoneE C

Improved anxiety
Improved depression
Improved exercise tolerance
Reduced chest pain
Reduced disability

This study evaluated the effectiveness of a psychological treatment package for patients with continuing chest pain despite cardiological reassurance following haemodynamically normal angiography. The treatment was found to significantly reduce chest pain episodes, improve anxiety and depression scores, and enhance exercise tolerance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Cognitive-behavioral therapy for noncardiac chest pain: a randomized trial.

Author: van Peski-OosterbaanA S, SpinhovenP, van RoodY, van der DoesJ W, BruschkeA V, RooijmansH G

Chest pain reduction

Cognitive-behavioral therapy was effective in reducing the frequency and intensity of chest pain in patients with noncardiac chest pain compared with usual care. Forty-eight percent of patients in the treatment group were pain-free at 12-month follow-up compared with 13% of patients in the control group.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Randomized trial of sertraline in patients with unexplained chest pain of noncardiac origin.

Author: VariaI, LogueE, O'connorC, NewbyK, WagnerH R, DavenportC, RatheyK, KrishnanK R

Reduced chest pain severity

This study investigated the potential benefits of sertraline in reducing chest pain of noncardiac origin in patients with symptoms similar to angina but normal coronary angiograms.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy.

Author: KiselyS, CampbellL A, SkerrittP

Chest pain treatment

The study reviewed research on psychological interventions for patients with recurrent chest pain in the absence of coronary artery disease, highlighting the need for more clinical trials to evaluate treatment effectiveness.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy.

Author: JonesH, CooperP, MillerV, BrooksN, WhorwellP J

Chest pain treatment

This study explores the potential of hypnotherapy for treating non-cardiac chest pain (NCCP), a condition that can be very distressing and difficult to manage. Hypnotherapy has been shown to be effective in similar conditions like irritable bowel syndrome and can provide lasting benefits. The study suggests that hypnotherapy could be a valuable tool for managing NCCP.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial.

Author: StochkendahlMette J, ChristensenHenrik W, VachWerner, Høilund-CarlsenPoul Flemming, HaghfeltTorben, HartvigsenJan

Improved acute chest pain treatment
Acute chest pain

Chest pain is a major health concern in Western countries. While focus is on diagnosing and treating potentially life-threatening heart conditions, chest pain can also be caused by problems with muscles, joints, and bones in the chest or neck. There's limited research on diagnosing and treating chest pain caused by these other problems.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

[Clinical observation on injection of small dose of morphine into Neiguan (PC 6) for treatment of chest pain in the patient with acute myocardial infarction].

Author: ZhangXue-Yu, LiWen-Hui, WenTang-Fang, LiChun-Hai, ChengZheng, ZhangXiu-Li, SuXin-Jing

Effective treatment
Reduced complications

Injection of a small dose of morphine into the Neiguan (PC 6) acupoint was more effective than intravenous or hypodermic injection for treating chest pain in acute myocardial infarction. The acupoint injection provided faster analgesia, required a smaller dose, and had fewer complications.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Chinese

9.

Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy.

Author: KiselySteve R, CampbellLeslie Anne, SkerrittPaul, YellandMichael J

Chest pain treatment

This review examines the effectiveness of psychological interventions for recurrent chest pain in patients without coronary artery disease, a common problem that can lead to excessive healthcare utilization.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Systematic review: the treatment of noncardiac chest pain.

Author: HershcoviciT, AchemS R, JhaL K, FassR

NCCP treatment
Reduces chest pain
Side effects
Toxicity

Patients with GERD-related noncardiac chest pain should be treated with at least double dose PPI. The primary treatment for non-GERD-related noncardiac chest pain, regardless if oesophageal dysmotility is present, is pain modulators.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Chiropractic treatment vs self-management in patients with acute chest pain: a randomized controlled trial of patients without acute coronary syndrome.

Author: StochkendahlMette J, ChristensenHenrik W, VachWerner, Høilund-CarlsenPoul F, HaghfeltTorben, HartvigsenJan

Treatment of musculoskeletal chest pain

This study compared the effectiveness of two treatments for acute chest pain caused by problems in muscles and bones: 1) chiropractic treatment that involved spinal manipulation and 2) self-management, which is a minimal intervention approach.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Treatment of functional chest pain with antidepressants: a meta-analysis.

Author: WangWen, SunYong-Hai, WangYa-Yu, WangYu-Tong, WangWei, LiYun-Qing, WuSheng-Xi

Reduced pain
Reduced psychological symptoms
Increased side effects

Antidepressant medications are associated with improvements in pain and psychological symptoms in patients with functional chest pain (FCP).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy.

Author: KiselySteve R, CampbellLeslie Anne, YellandMichael J, PaydarAnita

Improved recurrent chest pain treatment

This review examines the effectiveness of psychological interventions for recurrent chest pain in patients without coronary artery disease, a common problem that can lead to excessive healthcare utilization.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

Treatment efficacy for non-cardiovascular chest pain: a systematic review and meta-analysis.

Author: BurgstallerJakob M, JenniBoris F, SteurerJohann, HeldUlrike, WertliMaria M

Improved quality of life
Reduced disease burden
Non-cardiovascular chest pain

Proton pump inhibitors (PPIs) are effective in treating gastroesophageal reflux disorders (GERD) in patients with non-cardiovascular chest pain (NCCP). For idiopathic NCCP, treatments based on cognitive behavioral principles may be considered. More research is needed to evaluate the effectiveness of treatments for other prevalent diseases associated with chest pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy.

Author: KiselySteve R, CampbellLeslie A, YellandMichael J, PaydarAnita

Excess use of medical care

Recurrent chest pain without coronary artery disease is a common problem that can lead to excessive medical care. This updated Cochrane review examines the effectiveness of psychological interventions for these patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

An RCT of brief cognitive therapy versus treatment as usual in patients with non-cardiac chest pain.

Author: MulderRoger, ZarifehJulie, BodenJoseph, LaceyCameron, TyrerPeter, TyrerHelen, ThanMartin, TroughtonRichard

Reduced health anxiety

Brief CBT intervention for NCCP failed to reduce representations or improve psychological health over 12 months. Patients presenting with prior episodes of NCCP obtain benefit for a three month period.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Pragmatic Clinical TrialA trial conducted in a real-world clinical setting. It evaluates the effectiveness of interventions in everyday healthcare environments.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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