Chest pain in people with normal coronary anatomy

doi:10.1136/bmj.323.7325.1319

BMJ 2001;323:1319-1320 ( 8 December )

Editorials

Chest pain in people with normal coronary anatomy

Addressing patients' fears is a priority

The first 150 words of the full text of this article appear below.

Coronary angiography is often necessary for patients with chest pain, but 20% to 30% of examinations show normal anatomy.¹The use of angiography itself can contribute to symptoms in thesepatients, and non-organic factors are often overlooked. Providinga diagnosis may be less important than addressing a patient'sconcerns andfears.

Potentially irrevocable changes in social circumstances may occur while a patient is on a long waiting list. The mean waitingtime from the general practitioner's referral to angiography was261 days in the United Kingdom in 1994 and about 60 days in Canadain 1993. ² ³ These delays provide ample time for adverse changesin lifestyle, work patterns or even losing a job, restrictionin social and leisure activity, and disruption of family life.Such changes are directly related to time on the waiting listfor coronary bypass grafting, and the same is probably true forangiography.⁴ This means that patients can be . . . [Full text of this article]

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