ABSTRACT
Chest pain is an almost universal experience. Most people have experienced chest pain at times without being concerned by it. Someone referred to a cardiac service with chest pain is likely to have tests to rule out coronary disease. If the test results are normal, the pain is likely to be labelled non-cardiac chest pain (NCCP), and further investigations of alternative possible mechanisms for the pain are not routinely performed. The incidence of NCCP depends on the clinical setting. Coronary angiography is performed diagnostically in some patients admitted with acute chest pain even without abnormalities of the ECG or cardiac biomarkers. One mechanism of NCCP is an abnormal thoracic, as opposed to a normal abdominal, breathing pattern. Persistence of chest pain is strongly related to biopsychosocial factors. Symptoms are likely to continue if an underlying organic non-cardiac source of pain or psychological factors, such as health anxiety, are not addressed.
