Rome IV Diagnostic Criteria for Functional Chest Pain
Official Rome IV criteria for the diagnosis of functional chest pain.
Use in patients with symptoms suggestive of functional chest pain such as recurrent, unexplained chest pain or discomfort for at least 6 months.
Patients with any of the following features must be evaluated clinically for other diagnoses even though functional chest pain may be present:
-
Symptoms suggestive of cardiac ischemia.
-
Dysphagia.
-
Unexplained iron deficiency anemia.
-
Unintentional weight loss.
-
Palpable cervical lymphadenopathy on exam.
-
Persistent vomiting.
If diagnostic criteria are not met (negative):
Symptoms are unlikely to be caused by functional chest pain. Consider further assessment for other diseases or a different functional GI disorder.
If meets diagnosis (positive):
Likely diagnosis of functional chest pain.
Management of functional chest pain may include:
-
Tricyclic antidepressants (TCAs).
-
Selective serotonin reuptake inhibitors (SSRIs).
-
Serotonin noradrenergic reuptake inhibitors (SNRIs).
-
Trazodone.
-
Behavioral therapy (e.g. cognitive behavioral therapy [CBT], hypnosis).
This calculator should only be used in patients who do not have signs or symptoms suggestive of cardiac disease, or a structural/mechanical, metabolic or systemic cause of their symptoms based on clinical history, physical exam and initial work-up.