Interventions for non-specific chest pain

Most cases of chest pain are unrelated to cardiovascular disease. In many cases there is no obvious cause, but some patients are not reassured by the absence of disease.

As there is often psychiatric comorbidity, such as panic disorder, in people who experience chest pain, studies have looked at the effectiveness of psychological interventions.  The University of Queensland has now reviewed 10 of these trials.

The psychological interventions included cognitive behavioural therapy in six studies, hypnotherapy, hyperventilation control and relaxation training. Apart from brief cognitive therapy, all the interventions increased the number of days patients were free of pain. This benefit was maintained for 3–9 months.

Cognitive behavioural therapy and guided re-breathing significantly reduced the frequency of chest pain. This benefit was not maintained beyond three months.

Two studies assessed the severity of the chest pain. While