Before the diagnosis: quality of life in patients presenting with chest pain undergoing Bruce protocol stress testing

BACKGROUND: A stress test is commonly used as an initial evaluation tool for determining a possible cardiac origin for chest pain. This study was performed to test the hypothesis that patients with a positive stress test will have a significantly lower health-related quality of life (HRQoL) than patients with a negative stress test. METHODS: This study was a two-group non-experimental design where group assignment was based on the result of the stress test. Participants completed an HRQoL questionnaire (EuroQol-5D) prior to performing the Bruce treadmill stress test. The stress test was considered positive if participants reported chest pain or developed electrocardiogram ST-T changes or arrhythmia during the test. RESULTS: A total of 123 participants completed the study with 33 participants with a positive stress test and 90 participants with a negative stress test. Participants with a negative stress test reported a significantly lower (p = 0.014) HRQoL as compared to participants with a positive stress test. In the overall sample, current smokers (p < 0.001) and women (p = 0.02) were found to have a lower HRQoL. CONCLUSIONS: Patients with non-cardiac chest pain can experience lower HRQoL. The HRQoL was not related to results of the diagnostic testing. This study underscores that patients with non-cardiac chest pain could benefit from additional psychological assessment and treatment.