Evidence map›Paper›PMID 28196622›Full record

ReviewPsychosomatics

Non-cardiac Chest Pain: A Review for the Consultation-Liaison Psychiatrist.

Kirsti A Campbell, Elizabeth N Madva, Ana C Villegas, Eleanor E Beale, Scott R Beach, Jason H Wasfy, Ariana M Albanese, Jeff C Huffman

Abstract readReview
In one paragraph

Review in Psychosomatics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Non-Cardiac Chest Pain as a Persistent Physical Symptom: Psychological Distress and Workability.International journal of environmental research and public health · 2023
    Article
  13. Article
  14. Review
  15. Article
  16. Neurological Causes of Chest Pain.Current pain and headache reports · 2021
    Review
  17. Identifying and managing functional cardiac symptoms.Clinical medicine (London, England) · 2021
    Article
  18. Ogilvie's Syndrome Presented as Angina: A Case Report.European journal of case reports in internal medicine · 2020
    Article
  19. Is Noncardiac Chest Pain Truly Noncardiac?Clinical Medicine Insights. Cardiology · 2020
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Kirsti A CampbellHarvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Elizabeth N MadvaHarvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Ana C VillegasDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA.
Eleanor E BealeDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA.
Scott R BeachHarvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Jason H WasfyHarvard Medical School, Boston, MA; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
Ariana M AlbaneseDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA.
Jeff C HuffmanHarvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA. Electronic address: jhuffman@partners.org.

Funding

Harvard Clinical and Translational Science CenterKL2TR001100 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$8.5M
Developing a positive psychology intervention to improve cardiac health behaviorsR01HL113272 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI HUFFMAN, JEFF C · 2013 to 2017
$2.6M
Fostering Research Mentorship & Training during Psychiatry Residency SupplementR25MH094612 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI FAVA, MAURIZIO, GREENFIELD, SHELLY F. · 2011 to 2022
$2.3M
NCATS NIH HHS KL2 TR001100NHLBI NIH HHS R01 HL113272NIMH NIH HHS R25 MH094612
6 · The paper itself

Abstract

backgroundPatients presenting with chest pain to general practice or emergency providers represent a unique challenge, as the differential is broad and varies widely in acuity. Importantly, most cases of chest pain in both acute and general practice settings are ultimately found to be non-cardiac in origin, and a substantial proportion of patients experiencing non-cardiac chest pain (NCCP) suffer significant disability. In light of emerging evidence that mental health providers can serve a key role in the care of patients with NCCP, knowledge of the differential diagnosis, psychiatric co-morbidities, and therapeutic techniques for NCCP would be of great use to both consultation-liaison (C-L) psychiatrists and other mental health providers.

methodsWe reviewed prior published work on (1) the appropriate medical workup of the acute presentation of chest pain, (2) the relevant medical and psychiatric differential diagnosis for chest pain determined to be non-cardiac in origin, (3) the management of related conditions in psychosomatic medicine, and (4) management strategies for patients with NCCP.

resultsWe identified key differential diagnostic and therapeutic considerations for psychosomatic medicine providers in 3 different clinical contexts: acute care in the emergency department, inpatient C-L psychiatry, and outpatient C-L psychiatry. We also identified several gaps in the literature surrounding the short-term and long-term management of NCCP in patients with psychiatric etiologies or co-morbid psychiatric conditions.

conclusionsThough some approaches to the care of patients with NCCP have been developed, more work is needed to determine the most effective management techniques for this unique and high-morbidity population.

Indexed as

Referral and ConsultationAnxiety DisordersChest PainDiagnosis, DifferentialHumansMajor Depressive DisorderPanic DisorderStress Disorders, Post-Traumaticcardiacconsultation psychiatrydisease managementnon-cardiac chest painpsychosomatic medicine

Identifiers

PMID28196622
PMCPMC5526698

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.