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Chest Pain in Patients With Cardiac and Noncardiac Disease

From the University of Florida and the Malcom Randall VA Medical Center, Gainesville, Florida (D.S.S.); the School of Psychiatry and Behavioural Science, University of Manchester, U.K. (F.C.); and the Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri (R.E.C.).

Address correspondence and reprint requests to David S. Sheps, MD, MSPH, University of Florida, P.O. Box 100181, Gainesville, FL 100181–0181. E-mail: shepsds{at}medicine.ufl.edu

ABSTRACT

OBJECTIVE: To describe factors influencing chest pain expression in patients with cardiac or noncardiac disease.

METHODS: The authors conducted a case presentation and review of literature.

RESULTS: Causes of chest pain are diverse. Psychologic factors influence chest pain expression commonly in patients with or without cardiac disease.

CONCLUSIONS: Physicians and other therapists must be aware of psychologic influences on chest pain expression to provide optimal treatment to their patients.

Key Words: chest pain, • angina, • ischemia, • depression.

Abbreviations: PIMI = Psychophysiologic Investigations of Myocardial Ischemia;; GERD = gastroesophageal reflux disease.

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