Exclude cardiac cause prior to GI eval [S/L]

¹² A systematic review suggests that response of noncardiac chest pain to PPI trial was significantly higher vs placebo in pts w/ objective GERD evidence (endoscopy and/or pH monitoring), while response vs placebo was almost nonexistent in absence of objective GERD documentation. <br><br> ¹³ Do not initiate tx before diagnostic eval [C/M]. Consider endoscopy early for elderly, pts at risk for Barrett’s, noncardiac chest pain, and pts unresponsive to PPI. If alarm sx (eg, dysphagia) or high risk of GERD complications: endoscopy recommended.