Causes and characteristics of the chest pain(in the chest-pain clinic)

Choi, Yong Sun; Suh, Hye Sook; Yoo, Young Hoon; Kim, Hyung Soo; Kim, Mee Young; Yoon, Jong Lull

Abstract

BACKGROUND
Ischemic heart disease is the most important cause of the chest pain, and its frequency is increasing enormously. The purpose of this study is to find out the way of early detection and/or ruling out the cardiogenic chest pain by history taking.
METHODS
From July 1996 to December 1999, 248 patients visited the chest-pain clinic and took the questionnaire about characteristics of the chest pain. And we found out the diagnosis that caused the chest pain. 46 patients of them were excluded because of the unreliable responses or uncertain diagnosis. So, we compared the characteristics of the chest pain with causes for 202 patients.
RESULTS
The sex ratio of patients was 1.43:1(male:female). The average age was 41.8+/-14.0 for male and 47.3+/-14.8 for female. The causes of the chest pain were cardiogenic(23.2%), musculo-skeletal(19.3%), psychogenic (14.8%), gastrointestinal(12.4%), and pulmonary disease(6.9%). Patients with the past history of diabetes, hypertension, alcohol intake, or angina were more likely to have cardiac disease. Choking (O.R=2.19, C.I.=1.08-4.44), splitting(O.R=3.38, C.I.=1.24-9.21), or exploding pain (O.R=2.65, C.I=1.02-6.88) was more likely to be originated from cardiac disease. And patients with cardiogenic chest pain aggravated their symptoms by climbing the stairs(O.R=3.47, C.I= 1.52-7.90). But, pricking pain(O.R=0.18, C.I.= 0.04,-0.82) or chest pain associated with dyspepsia(O.R.=0.16, C.I.=0.04-0.69) was less likely to be originated from cardiac disease.
CONCLUSION
For detection and/or ruling out the cardiogenic chest pain, we have to check out characteristics of the pain, but also factors that associated with the pain or aggravating the pain.