An Evaluation of the Diagnostic Yield of OGD for Non-Cardiac Chest Pain

Aims: Patients with chest pain are frequently referred for endoscopy. We aim to determine the diagnostic yield of endoscopy in this group.

Methods: All patients referred for assessment of chest or retrosternal pain over 42 months were identified from a prospective database. Each case was matched with three age- and sex-matched controls. Findings were classified as “likely to cause chest pain“, “may cause chest pain“ or “unlikely to cause chest pain“, and analysed using the „Data Desk 6.0” statistical package.

Results: 193 OGDs met the above criteria. 58% were female. The median age (±interquartile range) was 55 years (42–65). The study and control groups were demographically similar. The prevalence of endoscopic findings in both groups was similar (75%). In the study group, the commonest findings were gastritis (36%), reflux oesophagitis (29%), and hiatus hernia (27%). Five gastric and six duodenal ulcers were identified. The study group was more likely than the control group to have findings that were likely to cause chest pain (32%vs24%, p=0.03), or findings that may cause chest pain (37%vs22%, p≤0.0001).

Conclusions: Patients referred for endoscopy for assessment of chest pain are more likely to have conditions that may cause chest pain. However, a low yield of serious pathology was identified.