ABSTRACT
The chapter discusses how the meaning of chest pain has been shaped by social and cultural influences. Descriptions of non-cardiac chest pain (NCCP) recognizable to a modern physician or psychologist were recorded in 19th century America in civilians and Civil War soldiers. It was important as it was the main cardiac cause of discharge from the army. Numerous organic theories of causation were considered including infections, gas poisoning and undetected heart disease. In the 1970s, the term syndrome X was introduced for patients with chest pain despite normal coronary anatomy. Syndrome X was more common in women, while NCCP is seen approximately equally in both sexes, probably because apparently abnormal ST segment changes are more likely in women. Chest pain is a common symptom that causes individuals to seek acute care at emergency departments. Since chest pain can be a sign of a heart attack, this association not surprisingly is likely to prompt worry and seeking medical help.
