Managing recurrent nonischemic chest pain in the emergency department

Am J Emerg Med. 1997 Mar;15(2):170-2. doi: 10.1016/s0735-6757(97)90094-2.


Many patients who seek emergency evaluation for recurrent chest pain have had negative cardiac evaluations, sometimes including normal coronary angiograms. Despite reassurance, many of these patients return to emergency departments with complaints of chest pain. Studies have shown that one third to one half of these patients suffer from panic disorder characterized by attacks of intense fear accompanied by chest pain or discomfort, nausea, and shortness of breath. If panic disorder is identified, it can be successfully treated. This article explores the causes of recurrent nonischemic chest pain and offers treatment recommendations.

Publication types

  • Review

MeSH terms

  • Chest Pain / etiology*
  • Cognitive Behavioral Therapy
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Humans
  • Panic Disorder / complications*
  • Panic Disorder / diagnosis
  • Panic Disorder / therapy
  • Patient Acceptance of Health Care
  • Prognosis
  • Recurrence
  • Tranquilizing Agents / therapeutic use


  • Tranquilizing Agents