Patients with noncardiac chest pain and benign palpitations referred for cardiac outpatient investigation: a 6-month follow-up

Abstract

Objectives: The aims were to (a) study the characteristics and outcome in patients with noncardiac chest pain or benign palpitations referred for cardiac evaluation, (b) compare psychological characteristics in the two groups, (c) identify predictors of outcome (d) and explore characteristics of patients who wanted psychological treatment.

Methods: The patients (N=154) were first evaluated by a psychiatrist and than by a cardiologist at the initial attendance and by self report after 6 months.

Results: Thirty nine percent had at least one DSM-IV psychiatric disorder at attendance. At the 6-month follow-up, 43% still had clinically significant complaints and/or impaired function. Patients with palpitations were more likely to be female, younger and less likely to attribute cardiac symptoms to heart disease, but had otherwise similar psychological features to noncardiac chest pain patients. Depression score at attendance predicted significant complaints at follow-up. Interest in psychological treatment was associated with more fear of bodily sensations, more impaired function, and greater tendency to attribute symptoms to heart disease.

Conclusion: Psychiatric disorders were common. The 6-month outcome was poor and was associated with the depression score at attendance. Patients with fear of bodily symptoms and impaired function were most interested in psychological treatment.