Noncardiac Chest Pain: A Focus on Psychogenic Causes

Patients presenting with noncardiac chest pain of psychogenic origin are one of the more challenging clinical dilemmas to primary care medicine. Key aspects to recognition of these patients are predominance of autonomic complaints, multiple presentations, clustering of physical complaints and a repeated history of negative cardiac pathology, a clinical profile of anxiety or panic disorder. Therapy can be achieved by the use of benzodiazepines. Psychiatric consultation is to be sought following successful symptom abatement from a parenteral benzodiazepine challenge in the emergency department on successive occasions.