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Different psychological profiles in non-cardiac chest pain and coronary artery disease: a controlled study

Javier García-Campayo1, Fernando Rosel, Pedro Serrano

  • 1Servicio de Psiquiatría, Hospital Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain. jgarcamp@arrakis.es

Revista Espanola De Cardiologia
|March 4, 2010
PubMed

Insights

Differentiating non-cardiac chest pain from coronary artery disease is possible using psychological factors. A predictive model including alexithymia and specific coping strategies shows high accuracy in screening.

Area of Science:

  • Psychosomatic Medicine
  • Cardiology

Background:

  • Non-cardiac chest pain (NCCP) presents diagnostic challenges, often overlapping with coronary artery disease (CAD) symptoms.
  • Accurate differentiation between NCCP and CAD is crucial for appropriate patient management and resource allocation.

Purpose of the Study:

  • To identify clinical characteristics distinguishing non-cardiac chest pain from coronary artery disease.
  • To develop a predictive model for screening patients with chest pain.

Main Methods:

  • An observational case-control study involving 40 patients with NCCP and 40 with CAD.
  • Assessment of sociodemographic, medical, and psychological variables, including personality, alexithymia, and coping strategies.
  • Multivariate analysis to develop a predictive model.

Main Results:

  • Patients with NCCP reported lower emotional control, higher alexithymia, and increased use of religion and medical help seeking as coping mechanisms.
  • A predictive model incorporating alexithymia, quality of life, and coping strategies (religion, help seeking) achieved 85.4% sensitivity and 80.0% specificity.
  • No significant differences in overall personality were found between the groups.

Conclusions:

  • Psychological factors, particularly alexithymia and specific coping styles, are key differentiators between NCCP and CAD.
  • The developed predictive model shows potential as a screening tool to aid in distinguishing between these conditions.

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