Unexplained chest pain: the problem persists in 40% of cases 💔

Each year, among all the people who visit Canadian hospitals due to chest pain, around 400,000 leave without knowing the exact cause of their problem. What happens to people who find themselves in this situation? This is the question a research team from Laval University aims to answer in an article recently published in the Journal of Psychosomatic Research.


This team followed, for two years, 672 people who went to two hospitals in Lévis for chest pain. Medical exams conducted in the emergency room helped rule out the hypothesis of cardiac issues.

"These pains could be associated with panic attacks, gastroesophageal reflux, or muscle pain, but the fact is, we simply don't know the cause of this condition. That's why we refer to it as medically unexplained chest pain," explains the study's lead author, Guillaume Foldes-Busque, professor at the School of Psychology at Laval University.

The research team contacted these 672 individuals five times in the two years following their emergency room visit to ask about their physical and mental health. The data collected indicate that in 60% of cases, the problem tends to disappear in the first months after the emergency room visit. "For these people, it was a one-time event. The pain disappeared as it had come," comments Professor Foldes-Busque.

Others are not so fortunate. About 40% of the study's participants still experienced unexplained chest pain two years after their emergency room visit. The severity of the problem had worsened in 7% of cases, remained stable in 21%, and had slightly diminished in 13%. During the six months before the two-year follow-up, 23% of participants had experienced the pain at least once per month, and 9% experienced it at least once per week.

"This condition has negative effects on both the physical and mental health of these individuals as well as their quality of life," observes Professor Foldes-Busque. "For example, they may associate the pain with something potentially dangerous, which can lead them to avoid certain activities that they believe might trigger the pain."

Professor Foldes-Busque's team is now working to develop a tool that could be used early on to identify, based on a set of characteristics, those who are at risk of having persistent medically unexplained chest pain.

"Initially, these individuals could benefit from an online intervention designed to help them cope with the symptoms and reduce their impact. Those for whom this intervention is not sufficiently effective could be referred to a multidisciplinary team to better identify the physical and psychological factors that interact to sustain this unexplained chest pain."

The other co-authors of the study published in the Journal of Psychosomatic Research are Clermont Dionne, Marie-Andrée Tremblay, Stéphane Turcotte, Richard Fleet, Patrick Archambault, and Isabelle Denis.