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

Jonsbu, Egil; Dammen, Toril; Morken, Gunnar; Martinsen, Egil W.

doi:10.1016/j.genhosppsych.2010.03.003

Cited by 30 publications

(52 citation statements)

References 27 publications

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“…Many of them are not convinced by their negative cardiac diagnosis (11,18,26,60,61), and continue to experience symptoms, worry about heart disease, avoid activities that they think might be harmful to their heart, and seek medical help (4,61). These patients often seek care due to recurrent and persistent chest pain (5,12,41,62), but also because of symptom anxiety, anxiety due to possible serious disease and symptom severity (26,34). The high level of healthcare utilization contributes to high costs for the healthcare system and the society (2,3,26,63,64).…”

Section: The Impact Of Non-cardiac Chest Painmentioning

confidence: 99%

“…Anxiety disorders are common among patients with chronic pain (73). About four out of ten of patients with NCCP have an anxiety disorder (19,52,74), and about 35-55 % have a lifetime anxiety disorder (19,62). Patients with multiple pain conditions experience more severe anxiety, worse physical performance, and bodily symptoms (73).…”

Section: Cardiac Anxietymentioning

confidence: 99%

“…Anxiety disorders are a risk factor for future development of depression (75) and are associated with healthcare utilization (13). Anxiety is also related to continued chest pain in patients with NCCP (22) and increased attention to cardiopulmonary symptoms (38,62).…”

Section: Cardiac Anxietymentioning

confidence: 99%

“…Fear of body sensations is fear related to different body symptoms such as palpitations, dizziness and sweating (80). Fear of body sensations, particularly cardiopulmonary sensations, is common in patients with NCCP who attribute their pain to heart disease (62,81).…”

Section: Fear Of Body Sensations and Fear Avoidancementioning

confidence: 99%

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Improving care for patients with non-cardiac chest pain : Description of psychological distress and costs, and evaluation of an Internet-delivered intervention

Mourad¹

2015

Linköping University Medical Dissertations

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Introduction: More than half of all patients seeking care for chest pain do not have a cardiac cause for this pain. Despite recurrent episodes of chest pain, many patients are discharged without a clear explanation of the cause for their pain. A lack of explanation may result in a misinterpretation of the pain as being cardiac-related, causing worry and uncertainty, which in turn leads to substantial use of healthcare resources. Psychological distress has been associated with non-cardiac chest pain (NCCP), but there is limited research regarding the relationship between different psychological factors and their association with healthcare utilization. There is a need for interventions to support patients to manage their chest pain, decrease psychological distress, and reduce healthcare utilization and costs. Aim: The overall aim of this thesis was to improve care for patients with non-cardiac chest pain by describing related psychological distress, healthcare utilization and societal costs, and by evaluating an Internet-delivered cognitive behavioural intervention. Designs and methods: This thesis presents results from four quantitative studies. Studies I and II had a longitudinal descriptive and comparative design. The studies used the same initial cohort. Patients were consecutively approached within 2 weeks from the day of discharge from a general hospital in southeast Sweden. In study I, 267 patients participated (131 with NCCP, 66 with acute myocardial infarction (AMI), and 70 with angina pectoris (AP)). Out of these, 199 patients (99 with NCCP, 51 with AMI, 49 with AP) participated in study II. Participants were predominantly male (about 60 %) with a mean age of 67 years. Data was collected on depressive symptoms (Study I), healthcare utilization (Study I, II), and societal costs (Study II). Study III had a cross-sectional explorative and descriptive design. Data was collected consecutively on depressive symptoms, cardiac anxiety and fear of body sensations in 552 patients discharged with diagnoses of NCCP (51 % women, mean age 64 years) from four hospitals in southeast Sweden. Patients were approached within one month from the day of discharge. Study IV was a pilot randomized controlled study including nine men and six women with a median age of 66 years, who were randomly assigned to an intervention (n=7) or control group (n=8). The intervention consisted of a four-session guided Internet-delivered cognitive behavioural therapy (CBT) program containing psychoeducation, exposure to physical activity, and relaxation. The control group received usual care. Data was collected on chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms. Results: Depressive symptoms were prevalent in 20 % (Study IV) and 25 % (Study I, III) of the patients, and more than half of the patients still experienced depressive symptoms one year later (Study I). There were no significant differences in prevalence and severity of depressive symptoms between patients diagnosed with NCCP, AMI or AP. Living a...

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Section: The Impact Of Non-cardiac Chest Painmentioning

confidence: 99%

Section: Cardiac Anxietymentioning

confidence: 99%

Section: Cardiac Anxietymentioning

confidence: 99%

Section: Fear Of Body Sensations and Fear Avoidancementioning

confidence: 99%

See 2 more Smart Citations

Improving care for patients with non-cardiac chest pain : Description of psychological distress and costs, and evaluation of an Internet-delivered intervention

Mourad¹

2015

Linköping University Medical Dissertations

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“…Jonsbu E et al in their study of 154 patients, noted psychiatric disorder at attendance in 39% study subjects and they were more likely to be females with younger age. 7 Barsky AJ et al in their study of 154 patients, had panic disorder in 40 (27.6%) patients of palpitation. 8 In a study done by Chignon et al, the prevalence of panic disorder in patients with palpitations was 15 to 31 percent.…”

mentioning

confidence: 92%

The aetiological profile of new onset palpitations in natives of Western Himalayas: a cross sectional observational study

et al. 2017

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Background: Palpitation is a common presenting complaint in out patient department. Etiological profile of such patients has not been studied in the recent past. The aim of the study was to study the aetiological profile of patients with new onset palpitations in North Indian tertiary health care centre.Methods: 130 consecutive patients of new onset palpitations were enrolled in the study and the aetiological profile of palpitation was evaluated using detailed history, examination and investigations.Results: The study group had 53% female and 47% male with a ratio of 1.13:1. Majority of the patients in the age group of 18-29 years. The mean age was 32.04+15.14 years. Most common symptom associated was shortness of breath seen in 17% patients. Of the 130 patients 43.8% of patients had cardiac aetiology, 35.38% psychiatric and 20% had miscellaneous aetiology. Among cardiac aetiology, arrhythmias were most common. PSVT was encountered in 15.4% and AF in 13.1%of the total patients. Psychiatry causes were observed in 35% of patients. In psychiatric causes 71.7% patients had panic attack whereas 28.2% patients had generalised anxiety disorder (GAD). In third group of miscellaneous causes which was 20% of total 6.9% had anaemia, 10% hyperthyroidism and 3.8% were on beta agonists.Conclusions: Palpitation is a presenting symptom of various diseases. The cause can be easily ascertained in most of the patients by a good history and examination; serious cardiac diseases require special investigation. Palpitation as a symptom should not be overlooked the underlying cause must be identified; this can be a helpful clue to improve patient outcome.

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Heart-focused anxiety and health care seeking in patients with non-cardiac chest pain: A prospective study

Tremblay

Denis

Turcotte³

et al. 2018

General Hospital Psychiatry

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

Cited by 30 publications

References 27 publications

Improving care for patients with non-cardiac chest pain : Description of psychological distress and costs, and evaluation of an Internet-delivered intervention

Improving care for patients with non-cardiac chest pain : Description of psychological distress and costs, and evaluation of an Internet-delivered intervention

The aetiological profile of new onset palpitations in natives of Western Himalayas: a cross sectional observational study

Heart-focused anxiety and health care seeking in patients with non-cardiac chest pain: A prospective study

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