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Grief-Related Chest Pain: A Review, Conceptual Analysis, and Integrative Model.

Sophia R Evstigneev1, Frank H Wilhelm2, George M Slavich3

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Grief-related chest pain is common but poorly understood. This study proposes a theoretical model linking bereavement to chest pain via psychoneuroimmunological pathways, offering insights for patient care.

Keywords:
Takotsubo syndromebereavementchest paingriefpsychoneuroimmunologypsychophysiology

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Area of Science:

  • Psychoneuroimmunology
  • Cardiology
  • Grief Research

Background:

  • Chest pain is a frequent symptom during bereavement.
  • The physiological mechanisms linking grief to chest pain are under-investigated.
  • Existing research lacks a comprehensive model for grief-related chest pain.

Purpose of the Study:

  • To explore the psychoneuroimmunological mechanisms connecting bereavement and chest pain.
  • To develop a theoretical model of grief-related chest pain.
  • To propose a toolkit for assessing grief-related chest pain.

Main Methods:

  • Concept analysis using Rodger's approach.
  • Systematic literature review of 220 PubMed articles, with 49 included in the analysis.
  • Integration of findings on autonomic, hemodynamic, musculoskeletal, respiratory, neuroendocrine, and immune changes during grief.

Main Results:

  • Only four empirical studies specifically addressed grief-related chest pain without mechanisms.
  • 45 studies explored broader psychoneuroimmune processes in grief.
  • A theoretical model integrating physiological, neuroendocrine, and immune pathways was developed.

Conclusions:

  • Grief-related chest pain may be a key physical manifestation of grief.
  • The proposed model highlights the interplay of physiological responses to emotional distress.
  • Understanding these mechanisms can improve patient care and guide interventions.