title: Non-cardiac chest pain: a retrospective cohort study of patients who attended a Rapid Access Chest Pain Clinic.
abstract: BACKGROUND
  Rapid Access Chest Pain Clinics have recently been introduced to assist in the management of primary care patients experiencing suspected cardiac chest pain.
  
  
  OBJECTIVE
  To study the longer term outcome for patients referred to a Rapid Access Chest Pain Clinic and then given a non-cardiac diagnosis.
  
  
  METHODS
  The study collected retrospective data from a cohort of all patients attending the Rapid Access Chest Pain Clinic based in the cardiorespiratory Department at the York District Hospital, England. Questionnaires were sent to all patients who attended the Rapid Access Chest Pain Clinic during the previous 14 months and were diagnosed with non-cardiac chest pain. Participants reported on their chest pain, subsequent episodes of primary and secondary care and their beliefs about causation of pain.
  
  
  RESULTS
  Of the patients referred to the Rapid Access Chest Pain Clinic, 235 (52%) did not have cardiac chest pain. Of these patients, 161 (69%) returned the questionnaire, nearly half of whom reported ongoing chest pain. The mean time since Clinic attendance was approximately 8 months and the median duration of ongoing chest pain was 5.4 months. Women were twice as likely as men to continue to be experiencing pain but did not report more frequent or severe pain on average. More than 50% of the non-cardiac group were not convinced by their negative cardiac diagnosis.
  
  
  CONCLUSIONS
  There is an ongoing challenge to support patients with non-cardiac chest pain, including the provision of reassurance that their pain is very unlikely to be caused by their heart.
authors.affiliation: Department of Health Sciences, University of York, and Cardiology Research Department, York District Hospital, York, UK. jd34@york.ac.uk
authors.forename: J C
authors.initials: JC
authors.lastname: Dumville
authors.forename: H
authors.initials: H
authors.lastname: MacPherson
authors.forename: K
authors.initials: K
authors.lastname: Griffith
authors.forename: J N V
authors.initials: JN
authors.lastname: Miles
authors.forename: R J
authors.initials: RJ
authors.lastname: Lewin
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000628:therapy*; D015331:Cohort Studies; D004739:England; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011320:Primary Health Care; D012189:Retrospective Studies; D013222:State Medicine; D011795:Surveys and Questionnaires