title: Do patients with chronic heart failure have chest pain?
abstract: OBJECTIVE
  In questionnaire surveys, patients with chronic heart failure frequently report "pain" as a symptom. We investigated the prevalence of chest pain as a possible cause for pain, particularly in patients with prior myocardial infarction.
  
  
  METHODS
  Questionnaire survey.
  
  
  METHODS
  Community heart failure clinic.
  
  
  METHODS
  1 786 patients with heart failure due to left ventricular systolic dysfunction (mean ± SD age 70.1 ± 11.0 years; 73% male; left ventricular ejection fraction (LVEF) 35.3 ± 9.9%; 65.6 with underlying ischaemic heart disease (IHD)).
  
  
  METHODS
  Patients with chronic heart failure completed a questionnaire.
  
  
  METHODS
  Answers to the questions: (1) "In the last week, how many days did you get angina chest pain?"; and "In the last month, how much did the following affect you:" (2) "chest pains at rest"; (3) "chest pains during normal activity".
  
  
  RESULTS
  73% of those with IHD, and 84% of those without had had no angina in the previous week; 79% and 82%, respectively, had at most "little" chest pain at rest; 67% and 76%, respectively, had at most "little" chest pain during exertion. Angina increased with NYHA class, but there was no relation between angina and sex of patient, age or LVEF. There was a weak relation between chest pain and an adverse outcome in the patients with ischaemic heart disease.
  
  
  CONCLUSIONS
  Although pain is commonly reported in patients with chronic heart failure, it seems unlikely that the pain is due to angina, even in patients with underlying coronary heart disease.
authors.affiliation: Department of Academic Cardiology, Castle Hill Hospital, Castle Road, Cottingham, Hull HU16 5JQ UK. a.l.clark@hull.ac.uk
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Clark
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Goode
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D011795:Surveys and Questionnaires