What they don't teach you in medical school: helping the patient with chest pain of unknown cause

Br J Hosp Med (Lond). 2022 Jan 2;83(1):1-7. doi: 10.12968/hmed.2021.0455. Epub 2022 Jan 26.

Abstract

Chest pain is a common presenting complaint with a broad differential diagnosis. Even after the full array of special investigations, a cause cannot be found in some patients. Psychological factors can play a significant role in the perception of chest pain. Patients with such a psychological disturbance may not meet the full criteria for a diagnosable psychiatric illness, and thus cannot be assigned a specific diagnosis. Not knowing how to manage this situation can lead to poor rapport between doctor and patient. Through their clinical acumen, judicious use of special investigations and by forming a therapeutic alliance, clinicians can identify and help these patients.

Keywords: Chest pain; Clinical approach; Functional disorder; Psychogenic pain.

MeSH terms

  • Chest Pain / diagnosis
  • Chest Pain / etiology
  • Diagnosis, Differential
  • Humans
  • Mental Disorders* / diagnosis
  • Schools, Medical*