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Unexplained chest pain with normal coronary arteriograms. A follow-up study
A Van Dorpe1, J Piessens, J L Willems
1Department of Cardiology, Universitair Ziekenhuis, St. Rafaël-Gasthuisberg, Leuven, Belgium.
Cardiology
|January 1, 1987
Summary
Patients with unexplained chest pain and normal coronary arteries often experience symptom resolution and return to normal activities. Persistent pain is linked to longer history and noncardiac health issues.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Unexplained chest pain with normal coronary arteries is a common clinical presentation.
- Long-term outcomes and prognostic factors for this patient group require further elucidation.
Purpose of the Study:
- To assess the long-term prognosis of patients presenting with unexplained chest pain and normal coronary arteries.
- To identify factors associated with persistent symptoms, noncardiac comorbidities, and return to work.
Main Methods:
- Prospective follow-up of 142 consecutive patients with unexplained chest pain and normal coronary arteries.
- Data collection included symptom duration, response to nitroglycerin, hospitalization history, and functional status at a mean follow-up of 49.3 months.
Main Results:
- No cardiac deaths and one myocardial infarction occurred during follow-up.
- Fifty percent of patients were pain-free, and two-thirds resumed normal activities.
- Persistent pain correlated with longer pain history, positive nitroglycerin response, increased noncardiac hospitalizations, and surgical interventions.
Conclusions:
- Unexplained chest pain with normal coronary arteries generally has a favorable long-term prognosis with low cardiac event rates.
- Symptom persistence is associated with a higher burden of noncardiac pathology and healthcare utilization.
- Factors like younger age, symptom resolution, and shorter pain history predict a better return to work.