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J Korean Acad Fam Med. 2001 Oct;22(10):1476-1483. Korean. Original Article.
Choi YS , Suh HS , Yoo YH , Kim HS , Kim MY , Yoon JL .
Department of Family Medicine, Hangang Sacred Heart Hospital.
Kangnam Sacred Heart Hospital, College of Medicine, Hallym University.
Department of Occupational medicine, Chung-ju medical center, College of Medicine, Kunkook University.
Department of Family Medicine, Hallym University Sacred Heart Hospital.
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.

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