[Unexplained non-cardiac chest pain; its prevalence and natural course]

(a) To assess whether data on prevalence and natural course of unexplained chest pain are similar to previous results reported for patients with unexplained chest pain in foreign literature; (b) to find biographical or medical record variables predictive of continuing pain.

Retrospective research of medical records.

University Medical Centre and Diaconessenhuis (peripheral hospital), Leiden, the Netherlands.

Medical records of patients who had been newly referred between 1992 and 1995 to the cardiac outpatient clinic were screened on the discharge diagnosis: unexplained chest pain. Patients were approached by mail with a questionnaire, inquiring about duration, frequency, intensity, functional limitations and medical consumption with regard to their unexplained chest pain.

In 39.8% (1053/2648) of the patients, no explanation was found for their complaints. After 12 and 24 months, 72% and 56% respectively reported still having complaints. 37% experienced limitations in daily activities at the time of the investigation. Sex and duration of pain before visiting the cardiologist were predictors of the persistence of chest pain. 31% of the patients did consult their general practitioner at least once more after the discharge by the cardiologist.

Unexplained chest pain is a common complaint of patients visiting an outpatient clinic for cardiology and often persists. The present results are largely similar to those reported in foreign literature.