The management of atypical non-cardiac chest pain.
Atypical, non-cardiac chest pain is common and disabling, and often persists despite negative medical investigations. Aetiology is disputed and management is difficult. A multi-causal model in which both psychological and physical factors play a part is helpful; a fundamental factor is continued misinterpretation of minor physical symptoms as evidence of heart disease. We report supportive evidence and describe a psychological treatment derived from the model. In a randomized trial, cognitive behavioural methods were effective in reducing chest pain, disability and use of medication, in patients both with and without psychiatric disorder. The clinical implications are discussed.
Pearce
M J
MJ
University Department of Psychiatry, Warneford Hospital, Oxford.
Mayou
R A
RA
Klimes
I
I
D000328:Adult; D001007:Anxiety; D002637:Chest Pain / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000523:psychology; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010200:Panic