Chest pain risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
Common [[ | Common underlying [[causes]] in the development of [[chest pain]] may be associated with the [[cardiac]], [[Respiratory system|respiratory]], or [[Gastrointestinal tract|gastrointestinal]] systems. [[Risk factors]] include [[smoking]], [[obesity]], [[drug abuse]], [[GERD] and [[psychiatric disorders]]. | ||
==Risk Factors== | ==Risk Factors== | ||
===Common Risk Factors=== | ===Common Risk Factors=== | ||
*[[Risk factors]] assessment is an important step in the evaluation of a patient presenting with [[chest pain]] for establishing the pretest risk. The CAD Consortium models assess [[age]], [[sex]], [[symptom]], [[hospital setting]], [[diabetes]], [[hypertension]], [[hyperlipidemia]] and [[smoking]].<ref name="pmid34709928">{{cite journal| author=Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK | display-authors=etal| title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2021 | volume= 144 | issue= 22 | pages= e368-e454 | pmid=34709928 | doi=10.1161/CIR.0000000000001030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34709928 }} </ref> | |||
*Common risk factors in the development of | *Common [[risk factors]] in the development of chest pain may be occupational, environmental, [[genetic]], and [[viral]] and include the following: <ref name="pmid29262011">{{cite journal |vauthors=Johnson K, Ghassemzadeh S |title= |journal= |volume= |issue= |pages= |date= |pmid=29262011 |doi= |url=}}</ref><ref name="pmid21602987">{{cite journal |vauthors=Fass R, Achem SR |title=Noncardiac chest pain: epidemiology, natural course and pathogenesis |journal=J Neurogastroenterol Motil |volume=17 |issue=2 |pages=110–23 |date=April 2011 |pmid=21602987 |pmc=3093002 |doi=10.5056/jnm.2011.17.2.110 |url=}}</ref><ref name="pmid15062436">{{cite journal |vauthors=Faybush EM, Fass R |title=Gastroesophageal reflux disease in noncardiac chest pain |journal=Gastroenterol. Clin. North Am. |volume=33 |issue=1 |pages=41–54 |date=March 2004 |pmid=15062436 |doi=10.1016/S0889-8553(03)00131-6 |url=}}</ref><ref> Galmiche JP, Clouse RE, Balint A, et al. Functional esophageal disorders. In: Drossman DA, Corazziari E, Delvaux M, Spiller RC, Talley NJ, Thompson WG, et al., editors. Rome III: The functional gastrointestinal disorders third edition. McLean, VA: Degnon Associates, Inc.; 2006. pp. 369–418. </ref> | ||
**'''Cardiac risk factors;''' | **'''Cardiac risk factors;''' | ||
**Advanced age | **Advanced age | ||
| Line 38: | Line 38: | ||
===Less Common Risk Factors=== | ===Less Common Risk Factors=== | ||
*Less common risk factors in the development of [disease name] include<ref name="pmid6416475">{{cite journal |vauthors=Bass C, Wade C, Hand D, Jackson G |title=Patients with angina with normal and near normal coronary arteries: clinical and psychosocial state 12 months after angiography |journal=Br Med J (Clin Res Ed) |volume=287 |issue=6404 |pages=1505–8 |date=November 1983 |pmid=6416475 |pmc=1549961 |doi=10.1136/bmj.287.6404.1505 |url=}}</ref><ref name="pmid8809520">{{cite journal |vauthors=Fruergaard P, Launbjerg J, Hesse B, Jørgensen F, Petri A, Eiken P, Aggestrup S, Elsborg L, Mellemgaard K |title=The diagnoses of patients admitted with acute chest pain but without myocardial infarction |journal=Eur. Heart J. |volume=17 |issue=7 |pages=1028–34 |date=July 1996 |pmid=8809520 |doi=10.1093/oxfordjournals.eurheartj.a014998 |url=}}</ref><ref name="pmid12752348">{{cite journal |vauthors=Eslick GD, Jones MP, Talley NJ |title=Non-cardiac chest pain: prevalence, risk factors, impact and consulting--a population-based study |journal=Aliment. Pharmacol. Ther. |volume=17 |issue=9 |pages=1115–24 |date=May 2003 |pmid=12752348 |doi=10.1046/j.1365-2036.2003.01557.x |url=}}</ref><ref name="pmid16439735">{{cite journal |vauthors=Demiryoguran NS, Karcioglu O, Topacoglu H, Kiyan S, Ozbay D, Onur E, Korkmaz T, Demir OF |title=Anxiety disorder in patients with non-specific chest pain in the emergency setting |journal=Emerg Med J |volume=23 |issue=2 |pages=99–102 |date=February 2006 |pmid=16439735 |pmc=2564064 |doi=10.1136/emj.2005.025163 |url=}}</ref> | *Less common risk factors in the development of [disease name] include: <ref name="pmid6416475">{{cite journal |vauthors=Bass C, Wade C, Hand D, Jackson G |title=Patients with angina with normal and near normal coronary arteries: clinical and psychosocial state 12 months after angiography |journal=Br Med J (Clin Res Ed) |volume=287 |issue=6404 |pages=1505–8 |date=November 1983 |pmid=6416475 |pmc=1549961 |doi=10.1136/bmj.287.6404.1505 |url=}}</ref><ref name="pmid8809520">{{cite journal |vauthors=Fruergaard P, Launbjerg J, Hesse B, Jørgensen F, Petri A, Eiken P, Aggestrup S, Elsborg L, Mellemgaard K |title=The diagnoses of patients admitted with acute chest pain but without myocardial infarction |journal=Eur. Heart J. |volume=17 |issue=7 |pages=1028–34 |date=July 1996 |pmid=8809520 |doi=10.1093/oxfordjournals.eurheartj.a014998 |url=}}</ref><ref name="pmid12752348">{{cite journal |vauthors=Eslick GD, Jones MP, Talley NJ |title=Non-cardiac chest pain: prevalence, risk factors, impact and consulting--a population-based study |journal=Aliment. Pharmacol. Ther. |volume=17 |issue=9 |pages=1115–24 |date=May 2003 |pmid=12752348 |doi=10.1046/j.1365-2036.2003.01557.x |url=}}</ref><ref name="pmid16439735">{{cite journal |vauthors=Demiryoguran NS, Karcioglu O, Topacoglu H, Kiyan S, Ozbay D, Onur E, Korkmaz T, Demir OF |title=Anxiety disorder in patients with non-specific chest pain in the emergency setting |journal=Emerg Med J |volume=23 |issue=2 |pages=99–102 |date=February 2006 |pmid=16439735 |pmc=2564064 |doi=10.1136/emj.2005.025163 |url=}}</ref> | ||
**[[Physical inactivity]] | **[[Physical inactivity]] | ||
**[[Drug abuse]], eg [[cocaine]] | **[[Drug abuse]], eg [[cocaine]] | ||
| Line 44: | Line 44: | ||
**Psychological comorbidity | **Psychological comorbidity | ||
**New exercise routine | **New exercise routine | ||
**Recent trauma | **Recent [[trauma]] | ||
**[[Viral infections]] | **[[Viral infections]] | ||
**[[Sickle cell disease]] | |||
====Increased age==== | |||
Increased age is a risk factor not only for [[acute coronary syndromes]] but also for other alternative diagnoses that present with chest pain.<ref name="pmid34709928">{{cite journal| author=Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK | display-authors=etal| title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2021 | volume= 144 | issue= 22 | pages= e368-e454 | pmid=34709928 | doi=10.1161/CIR.0000000000001030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34709928 }} </ref> | |||
====Sickle cell disease==== | |||
Patients with [[sickle cell disease]] may present with chest pain in patients without traditional risk factors for [[acute coronary syndrome]] and must be evaluated for [[acute myocardial infarction]].<ref name="pmid34709928">{{cite journal| author=Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK | display-authors=etal| title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2021 | volume= 144 | issue= 22 | pages= e368-e454 | pmid=34709928 | doi=10.1161/CIR.0000000000001030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34709928 }} </ref> | |||
====Noncardiac [[chest pain]]==== | |||
* Noncardiac causes of [[chest pain]] including [[gastrointestinal]] and [[psychological]] have negative effect on the quality of life. | |||
* [[Gastrointestinal]] symptoms ([[heartburn]], [[dysphagia]], [[acid regurgitation]]) and [[psychological]] [[symtoms]] such as [[anxiety]], [[depression]], [[neuroticism]] should be consulted for noncardiac [[chest pain]].<ref name="pmid12752348">{{cite journal |vauthors=Eslick GD, Jones MP, Talley NJ |title=Non-cardiac chest pain: prevalence, risk factors, impact and consulting--a population-based study |journal=Aliment Pharmacol Ther |volume=17 |issue=9 |pages=1115–24 |date=May 2003 |pmid=12752348 |doi=10.1046/j.1365-2036.2003.01557.x |url=}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
| Line 57: | Line 66: | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
[[Category:Up | [[Category:Up To Date]] | ||
Latest revision as of 15:40, 28 January 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]
Overview
Common underlying causes in the development of chest pain may be associated with the cardiac, respiratory, or gastrointestinal systems. Risk factors include smoking, obesity, drug abuse, [[GERD] and psychiatric disorders.
Risk Factors
Common Risk Factors
- Risk factors assessment is an important step in the evaluation of a patient presenting with chest pain for establishing the pretest risk. The CAD Consortium models assess age, sex, symptom, hospital setting, diabetes, hypertension, hyperlipidemia and smoking.[1]
- Common risk factors in the development of chest pain may be occupational, environmental, genetic, and viral and include the following: [2][3][4][5]
- Cardiac risk factors;
- Advanced age
- Previous history of myocardial infarction
- History of valvular disorders
- Pericarditis and myocarditis
- Family history of cardiomyopathies
- Hypertension
- High blood lipids
- Diabetes
- Tobacco use
- Pulmonary risk factors;
- Prior history of pulmonary embolism or DVTs
- Hormonal contraceptive use
- Malignancies
- Recent surgery
- Immobilization
- History of pneumonia
- Trauma/pulmonary contusion
- Pneumothorax or pleural effusion
- Gastrointestinal Risk factors;
- Obesity
- Pregnancy
- Hiatal hernia
- Recent gastroesophageal procedures involving scopes
- Boerhaave syndrome
Less Common Risk Factors
- Less common risk factors in the development of [disease name] include: [6][7][8][9]
- Physical inactivity
- Drug abuse, eg cocaine
- History of esophageal motility/hypersensitivity disorders
- Psychological comorbidity
- New exercise routine
- Recent trauma
- Viral infections
- Sickle cell disease
Increased age
Increased age is a risk factor not only for acute coronary syndromes but also for other alternative diagnoses that present with chest pain.[1]
Sickle cell disease
Patients with sickle cell disease may present with chest pain in patients without traditional risk factors for acute coronary syndrome and must be evaluated for acute myocardial infarction.[1]
Noncardiac chest pain
- Noncardiac causes of chest pain including gastrointestinal and psychological have negative effect on the quality of life.
- Gastrointestinal symptoms (heartburn, dysphagia, acid regurgitation) and psychological symtoms such as anxiety, depression, neuroticism should be consulted for noncardiac chest pain.[8]
References
- ↑ 1.0 1.1 1.2 Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK; et al. (2021). "2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 144 (22): e368–e454. doi:10.1161/CIR.0000000000001030. PMID 34709928 Check
|pmid=value (help). - ↑ Johnson K, Ghassemzadeh S. PMID 29262011. Missing or empty
|title=(help) - ↑ Fass R, Achem SR (April 2011). "Noncardiac chest pain: epidemiology, natural course and pathogenesis". J Neurogastroenterol Motil. 17 (2): 110–23. doi:10.5056/jnm.2011.17.2.110. PMC 3093002. PMID 21602987.
- ↑ Faybush EM, Fass R (March 2004). "Gastroesophageal reflux disease in noncardiac chest pain". Gastroenterol. Clin. North Am. 33 (1): 41–54. doi:10.1016/S0889-8553(03)00131-6. PMID 15062436.
- ↑ Galmiche JP, Clouse RE, Balint A, et al. Functional esophageal disorders. In: Drossman DA, Corazziari E, Delvaux M, Spiller RC, Talley NJ, Thompson WG, et al., editors. Rome III: The functional gastrointestinal disorders third edition. McLean, VA: Degnon Associates, Inc.; 2006. pp. 369–418.
- ↑ Bass C, Wade C, Hand D, Jackson G (November 1983). "Patients with angina with normal and near normal coronary arteries: clinical and psychosocial state 12 months after angiography". Br Med J (Clin Res Ed). 287 (6404): 1505–8. doi:10.1136/bmj.287.6404.1505. PMC 1549961. PMID 6416475.
- ↑ Fruergaard P, Launbjerg J, Hesse B, Jørgensen F, Petri A, Eiken P, Aggestrup S, Elsborg L, Mellemgaard K (July 1996). "The diagnoses of patients admitted with acute chest pain but without myocardial infarction". Eur. Heart J. 17 (7): 1028–34. doi:10.1093/oxfordjournals.eurheartj.a014998. PMID 8809520.
- ↑ 8.0 8.1 Eslick GD, Jones MP, Talley NJ (May 2003). "Non-cardiac chest pain: prevalence, risk factors, impact and consulting--a population-based study". Aliment. Pharmacol. Ther. 17 (9): 1115–24. doi:10.1046/j.1365-2036.2003.01557.x. PMID 12752348.
- ↑ Demiryoguran NS, Karcioglu O, Topacoglu H, Kiyan S, Ozbay D, Onur E, Korkmaz T, Demir OF (February 2006). "Anxiety disorder in patients with non-specific chest pain in the emergency setting". Emerg Med J. 23 (2): 99–102. doi:10.1136/emj.2005.025163. PMC 2564064. PMID 16439735.