Chest Pain

National and International Guidelines

NICE CG95 Chest pain of recent onset.

Cochrane Reviews

Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy.

Kisely SR, Campbell LA, Yelland MJ, Paydar A. Cochrane Database of Systematic Reviews 2012, Issue 6


Recurrent chest pain in the absence of coronary artery disease is a common, difficult to treat problem that sometimes leads to excess use of medical care. A substantial number of patients are not reassured by negative medical assessment, reporting persistent pain and limitations. Psychological factors appear to be of importance for treatment. This review included all studies of psychotherapy for non-cardiac chest pain. Due to the small number of studies, the reviewers were able to draw conclusions about cognitive-behavioural therapy only. The findings were based on 15 trials that were included in this review with a total of 803 participants. The review found that cognitive-behavioural treatments are probably effective, (in terms of reduced chest pain frequency) in the short term, for the treatment of non-cardiac related chest pain. No adverse effects of the psychotherapy were found. Hypnotherapy is also a possible alternative. A limitation of this review is the high variability of the studies included, reflected in a wide range of outcome measures, although there was an overall fairly low risk of bias.