• Jörg Haasenritter, Tobias Biroga, Christian Keunecke, Annette Becker, Norbert Donner-Banzhoff, Katharina Dornieden, Rebekka Stadje, Annika Viniol, and Stefan Bösner.
• Jörg Haasenritter, Philipps University of Marburg, Department of General Practice/Family Medicine, Karl-von-Frisch-Str. 4, 35043 Marburg, Germany, haasenri@staff.uni-marburg.de.
• Croat. Med. J. 2015 Oct 1; 56 (5): 422-30.

AimTo investigate the frequencies of different and relevant underlying etiologies of chest pain in general practice.MethodsWe systematically searched PubMed and EMBASE. Two reviewers independently rated the eligibility of publications and assessed the risk of bias of included studies. We extracted data to calculate the relative frequencies of different underlying conditions and investigated the variation across studies using forest plots, I(2), tau(2), and prediction intervals. With respect to unexplained heterogeneity, we provided qualitative syntheses instead of pooled estimates.ResultsWe identified 11 eligible studies comprising about 6500 patients. The overall risk of bias was rated as low in 6 studies comprising about 3900 patients. The relative frequencies of different conditions as the underlying etiologies of chest pain reported by these studies ranged from 24.5 to 49.8% (chest wall syndrome), 13.8 to 16.1% (cardiovascular diseases), 6.6 to 11.2% (stable coronary heart disease), 1.5 to 3.6% (acute coronary syndrome/myocardial infarction), 10.3 to 18.2% (respiratory diseases), 9.5 to 18.2% (psychogenic etiologies), 5.6 to 9.7% (gastrointestinal disorders), and 6.0 to 7.1% (esophageal disorders).ConclusionThis information may be of practical value for general practitioners as it provides the pre-test probabilities for a range of underlying diseases and may be suitable to guide the diagnostic process.

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