ABSTRACT
This chapter describes the most common non-cardiac, physical causes of chest pain. These include gastro-oesophageal disorders, musculoskeletal problems and respiratory disorders. The health professional must be confident that all appropriate tests have been completed to exclude heart disease before they consider using the following biopsychosocial model and the cognitive behavioural approach. Physical factors play an important role in the development and continuance of non-cardiac chest pain (NCCP). They form part of the vicious cycle of the biopsychosocial model. The gastro-oesophageal reflux is the most common gastrointestinal abnormality found in patients with NCCP, but these patients may still experience pain with normal levels of acid reflux. Between 5" and 30" of NCCP cases are thought to have a musculoskeletal origin. Chest pain is frequently interpreted as a sign of a heart attack or coronary disease by both the patient and other people. It is common for healthy people to experience sensations in the chest as a reaction to stress.
