Key result
Patients with non-cardiac chest pain reported atypical pain more frequently than those with cardiac chest pain (82% vs 50%, OR 3.72) and exhibited more panic-type beliefs.
Why the study?
Do patients with non-cardiac chest pain differ from those with cardiac chest pain in terms of clinical needs, distress, and health-care use?
Cross-Sectional
No
Do patients with non-cardiac chest pain differ from those with cardiac chest pain in terms of clinical needs, distress, and health-care use?
Patients with non-cardiac chest pain experience similar levels of distress and disability as those with cardiac chest pain but have different psychological needs and healthcare utilization patterns.
Answers are grounded in this paper and cite their sources.
Atypical pain and panic beliefs may indicate non-cardiac etiology; Level 4 data leaves open whether targeted assessment alters distress or utilization.
AIMS: To determine the characteristics, clinical needs and level of health-care use of patients with non-cardiac (NCCP) and cardiac-chest pain (CCP) attending a Rapid Access Chest Pain Clinic in an inner-London Hospital. METHODS: A cross-sectional comparison of NCCP and CCP patients on measures of pain, mood, beliefs, somatic symptoms and use of services completed by patients attending the Rapid Access Chest Pain Clinic over an 18-month period. RESULTS: There were no significant differences between NCCP and CCP patients in terms of chest pain frequency, duration or severity or associated distress; however, NCCP were younger (53 vs. 60, OR = 1.05) and reported 'atypical' pain more frequently (82% vs. 50%, OR = 3.72). The NCCP group reported more panic-type beliefs about chest pain (5.8 vs. 4.3, P < 0.05) and lower 'illness coherence' (a patient's belief that the illness 'makes sense') (3.5 vs. 4.7, P < 0.05). Anxiety and depression scores were similar in both groups. Both groups had similar levels of health-care use but patients with NCCP saw more types of health-care worker (mean 1.7) than those with CCP (mean 1.4, P < 0.05). CONCLUSION: Patients with NCCP are as disabled and distressed as patients with CCP however current services fail to meet their needs. We suggest that a biopsychosocial approach should be explored.
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Marks et al. (2014) conducted a cross-sectional in Chest pain (non-cardiac and cardiac). Non-cardiac chest pain (NCCP) vs. Cardiac chest pain (CCP) was evaluated on Atypical pain (OR 3.72). Patients with non-cardiac chest pain reported atypical pain more frequently than those with cardiac chest pain (82% vs 50%, OR 3.72) and exhibited more panic-type beliefs.
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