Approach to Non-Cardiac Chest Pain

This session provides a structured overview of the approach to non-cardiac chest pain.

The lecture focuses on the systematic evaluation of chest pain after excluding cardiac causes, emphasizing gastrointestinal, musculoskeletal, pulmonary, and psychological etiologies. Conditions such as GERD, esophageal motility disorders, costochondritis, and anxiety-related chest pain are reviewed with their key clinical features and distinguishing characteristics.

Diagnostic strategies include detailed history taking, physical examination, and risk stratification to exclude life-threatening conditions. Initial tests such as ECG and cardiac biomarkers are highlighted, while further evaluation may include upper gastrointestinal endoscopy, esophageal pH monitoring, manometry, and selected pulmonary investigations based on clinical suspicion.

Management is etiology-based, including PPIs for GERD, analgesics and physical therapy for musculoskeletal pain, and psychological support for anxiety-related cases. Emphasis is placed on avoiding unnecessary investigations and ensuring appropriate patient reassurance.

Following the lecture, a Kahoot quiz was held to reinforce key concepts, prizes were awarded to top-performing students, and the session concluded with an interactive Q&A.