BACKGROUND Patients complaining of chest pain are frequently referred to secondary care, although the majority have pain of non-cardiac origin. AIM To investigate whether B-type natriuretic peptide (BNP) levels are predictive of a diagnosis of non-cardiac pain. DESIGN Cross-sectional study. METHODS Consecutive patients (n = 296) presenting to a rapid-access chest pain clinic (RACPC) recei...

The focus of this article is to explore chest pain in children and adolescents. Common causes of chest pain and the approach to its evaluation are reviewed. Special emphasis is given to the cardiac causes of pediatric chest pain and how it can be differentiated from more common benign etiologies.

Introduction: Psychological symptoms of non-cardiac chest pain (NCCP) including perceptual, emotional, and behavioral problems can effect patient perception of chest pain. This study was conducted to determine the effect of metaphor therapy on mitigating depression, anxiety, stress, and pain discomfort in patients with NCCP. Materials and Methods: This randomized, controlled, trial was conducte...

The experience of cardiac chest pain is always traumatic and stressful for patients. The available literature suggests that although nurses place a lot of importance on cardiac patients being pain free, it is apparent this is often not achieved. Research and documented case studies suggest that relaxation can play an important role in the treatment and prevention of this distressing symptom (Ti...

Thoracic outlet syndrome is the result of compression or irritation of neurovascular bundles as they pass from the lower cervical spine into the arm, via the axilla. If the pectoralis minor muscle is involved the patient may present with chest pain, along with pain and paraesthesia into the arm. These symptoms are also commonly seen in patients with chest pain of a cardiac origin. In this case,...

INTRODUCTION We use clinical, ECG, and biochemical data to stratify risk in patients with chest pain without ST segment elevation. However, the prognostic performance of these studies in relation to time from onset of symptoms is unknown. PATIENTS AND METHOD In a single-center, prospective study, 321 consecutive patients who had been admitted in the emergency room with a suspected acute coron...

PURPOSE To compare standard of care nuclear SPECT imaging with cardiac magnetic resonance imaging (MRI) for emergency room (ER) patients with chest pain and intermediate probability for coronary artery disease. MATERIALS AND METHODS Thirty-one patients with chest pain, negative electrocardiogram (ECG), and negative cardiac enzymes who underwent cardiac single photon emission tomography (SPECT...

Noncardiac chest pain is defined as recurrent chest pain that is indistinguishable from ischemic heart pain after a reasonable workup has excluded a cardiac cause. Noncardiac chest pain is a prevalent disorder resulting in high healthcare utilization and significant work absenteeism. However, despite its chronic nature, noncardiac chest pain has no impact on patients' mortality. The main underl...

BACKGROUND AND OBJECTIVES Chest pain is a complaint for which children are frequently evaluated. Cardiac causes are rarely found despite expenditure of considerable time and resources. We describe validation throughout New England of a clinical guideline for cost-effective evaluation of pediatric patients first seen by a cardiologist for chest pain using a unique methodology termed the Standard...

Much of the focus of research on patients with chest pain is directed at technological advances in the diagnosis and management of acute coronary syndrome (ACS), pulmonary embolism (PE), and acute aortic dissection (AAD), despite there being no significant difference at 4 years as regards mortality, ongoing chest pain, and quality of life between patients presenting to the emergency department ...