Chest pain not in the textbook

Medical schools teach future doctors the typical characteristics of angina. In practice, however, patients may not present with these symptoms. GP researchers in London have studied how patients describe their pain, as part of a larger study of angina. A subsample of 64 patients already known to have, or were strongly suspected of having, coronary artery disease was interviewed.

While over half the patients said that they had a tight feeling in their chest, some patients described a sharp or stabbing pain. Some just complained of vague symptoms or discomfort.

Breathlessness was described by two-thirds of the patients. Some people put this down to respiratory problems. 

Patients sometimes attributed their symptoms to indigestion. Several people, including some who had experienced a myocardial infarction, underplayed the seriousness of their symptoms.


Clinical diagnosis of an ischaemic problem can be