Korean J Med.  2013 Apr;84(4):515-521.

Necessity of Upper Gastrointestinal Endoscopy in Patients with Noncardiac Chest Pain

Affiliations
  • 1Division of Gastroenterology and Hepatology, Konyang University College of Medicine, Konyang University Myunggok Medical Research Institute, Daejeon, Korea. ismkim@kyuh.ac.kr

Abstract

BACKGROUND/AIMS
Gastroesophageal reflux disease (GERD) is the most frequent cause of noncardiac chest pain (NCCP) in Western countries. Gastroduodenal disease has a high prevalence in Korea; thus, it is important to evaluate the stomach/duodenum. We retrospectively reviewed the findings in patients with chest pain who were diagnosed by coronary angiography (CAG) to be normal or who had minimal coronary lesions to evaluate the necessity of performing esophagogastroduodenoscopy (EGD) in patients with NCCP.
METHODS
A total of 565 patients with chest pain underwent CAG followed by EGD from February 2000 to March 2011 at Konyang University Hospital. We excluded patients who underwent EGD more than 3 days after CAG or had significant coronary lesions. We retrospectively reviewed the EGD findings of the remaining 349 patients.
RESULTS
Of the 349 patients, 151 were male, and the average age of the patients was 57.7+/-11.44 years. After performing EGD, GERD was diagnosed in 35 patients (10.0%; LA [Los Angeles classification]-A, 30; LA-B, three; LA-C, two) and peptic ulcer was diagnosed in 48 patients (13.8%; gastric ulcer, 34; duodenal ulcer, 10; gastric and duodenal ulcer, four). Gastritis was diagnosed in 253 patients (72.5%; erosive, 89; erythematous, 90; hemorrhagic, 10; mixed, 64). Duodenitis, esophagitis, Barrett's esophagus, hiatus hernia, and gastric cancer was diagnosed in 36 (10.3%), three (0.9%), two (0.6%), three (0.9%), and one patient, respectively.
CONCLUSIONS
Unlike the situation in the west, stomach/duodenal lesions other than GERD are common causes of NCCP in Korea, Therefore, prior to proton pump inhibitor testing or empirical therapy, EGD is necessary to evaluate NCCP and to rule out gastroduodenal lesions.

Keyword

Noncardiac chest pain; Endoscopy; Gastroesophageal reflux disease; Coronary angiography

MeSH Terms

Barrett Esophagus
Chest Pain
Coronary Angiography
Duodenal Ulcer
Duodenitis
Endoscopy
Endoscopy, Digestive System
Endoscopy, Gastrointestinal
Esophagitis
Gastritis
Gastroesophageal Reflux
Hernia, Hiatal
Humans
Korea
Male
Peptic Ulcer
Prevalence
Proton Pumps
Retrospective Studies
Stomach Neoplasms
Stomach Ulcer
Thorax
Proton Pumps
Full Text Links
  • KJM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr