Acute chest pain without obvious organic cause before age 40--personality and recent life events

Personality and life events were measured in 69 consecutive patients (36 men and 33 women) below age 40 attending the emergency care unit because of chest pain without obvious organic cause (91% participation rate). The results were compared with 32 randomly sampled healthy subjects matched with regard to age and sex (86% participation rate). The patient group had significantly higher scores for "neuroticism', 'Type A behaviour' and 'vital exhaustion'. Further more the patients had experienced significantly more life events, in particular uncontrollable ones, during the last year. We conclude that 'Type A behaviour', 'neuroticism', 'vital exhaustion' and critical recent life events are linked with emergency consultation for chest pain of non-cardiac origin. Possible explanations of the link between the psychological reaction and the chest pain are enhanced tension in the thoracic muscles producing chest pain and oesophageal disorders. This study stresses the importance of careful medical and psychosocial examination of each case of unexplained chest pain at the emergency care unit.