Necessity of Upper Gastrointestinal Endoscopy in Patients with Noncardiac Chest Pain.
- Author:
Jin Sil PYO
1
;
Sun Moon KIM
;
Yoo Jin UM
;
Joo Ah LEE
;
Hoon Sup KOO
;
Kyung Ho SONG
;
Yong Seok KIM
;
Tae Hee LEE
;
Euyi Hyeog IM
;
Kyu Chan HUH
;
Yong Woo CHOI
;
Young Woo KANG
Author Information
1. Division of Gastroenterology and Hepatology, Konyang University College of Medicine, Konyang University Myunggok Medical Research Institute, Daejeon, Korea. ismkim@kyuh.ac.kr
- Publication Type:Original Article
- Keywords:
Noncardiac chest pain;
Endoscopy;
Gastroesophageal reflux disease;
Coronary angiography
- MeSH:
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
- From:Korean Journal of Medicine
2013;84(4):515-521
- CountryRepublic of Korea
- Language:Korean
-
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.
