Atypical chest pain as an initial presentation of primary fibromyalgia

Four patients with atypical chest pain initially believed to be cardiac in origin were subsequently found to have primary fibromyalgia. All patients had characteristic findings of this condition, and the diagnosis was confirmed by demonstrating muscle tender and trigger points which reproduced the chest symptoms. None were found to have significant cardiac conditions, and all improved after a specific treatment program. Primary fibromyalgia should be suspected in patients with atypical chest pain. Appropriate treatment can result in optimal medical management and avoidance of costly medical tests.