Non-cardiac chest pain: why was a brief intervention apparently ineffective?

Psychol Med. 1997 Sep;27(5):1033-40. doi: 10.1017/s0033291797005266.


Background: Patients who present with chest pain but have normal coronary angiography and who are told by their cardiologist that they do not have heart disease, have a poor symptomatic, psychological and quality of life outcome and remain concerned about a serious cause of their symptoms. They frequently complain they have not had enough information. The study aimed to test the effectiveness and acceptability of a brief psychological intervention based on cognitive behavioural principles.

Methods: Consecutive patients with chest pain and normal angiograms were assessed and invited to take part in a randomized controlled evaluation. The intervention consisted of an individualized information and discussion session by a specially trained cardiac nurse, together with a handout and cassette providing information and advice and telephone follow-up to discuss progress, answer questions and reiterate advice.

Results: The treatment proved to be unacceptable to some patients and there was no evidence of efficacy.

Conclusions: Implications for the preparation of patients undergoing angiography and for the timing and delivery of information and advice following a negative result are discussed.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Attitude to Health
  • Chest Pain / psychology
  • Chest Pain / therapy*
  • Chi-Square Distribution
  • Coronary Angiography / psychology
  • Female
  • Follow-Up Studies
  • Heart Diseases / psychology*
  • Humans
  • Male
  • Patient Education as Topic / standards*
  • Patient Satisfaction
  • Relaxation Therapy / standards
  • Somatoform Disorders / therapy*
  • Treatment Outcome