Letter

Non-cardiac chest pain

BMJ 2002; 324 doi: 10.1136/bmj.324.7342.915 (Published 13 April 2002)
Cite this as: BMJ 2002;324:915.1

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Patients need diagnoses

  1. David S Coulshed, staff specialist in cardiology.,
  2. Guy D Eslick, gastroenterology fellow. (eslickg@med.usyd.edu.au),
  3. Nicholas J Talley, professor of medicine.
  1. Department of Cardiology, Nepean Hospital, Penrith, New South Wales 2751, Australia
  2. Department of Medicine, University of Sydney, Nepean Hospital, PO Box 63, Penrith
  3. Maryport, Cumbria CA15 8EL

    EDITOR—We are concerned about one of the sweeping conclusions in the editorial on non-cardiac chest pain.1 We do not agree that “providing a diagnosis may be less important than addressing a patient's concerns and fears.” Providing a diagnosis is probably the most important part of the care of such patients.

    Evidence shows that angiography fails to relieve the anxiety of patients,2 but the psychological and psychiatric complications of chest pain may be at least partially related to general practitioners' inability to provide a definite diagnosis. Continued prescription of antiangina drugs, and possibly failure to investigate further, contribute to continued …

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