Taking heartache to heart: Empirical psychological modelling of chest pain

The chest pain of patients visiting a cardiology out-patient's clinic is most often caused by coronary atherosclerosis, which induces an oxygen shortage in the heartmuscle and thereby pain. However, in approximately 30% of the chest pain patients no clear somatic cause can be found. Contemporary literature refers to these patients as suffering from cardiophobia. For a closer look at this disorder it is imperative to understand the different types of chest pain and the various possible causes of it. As far as the type of chest pain is concerned a difference can be made between chest pain typical, atypical and nontypical for angina pectoris. Typical chest pain is diagnosed when there is a 1) substernal chest pain or pressure, 2) usually brought on predominantly by exertion, emotion or temperature changes and 3) relieved promptly at rest or with nitroglycerine. Chest pain is considered to be atypical when only two of the three factors are present and when only one characteristic is present the chest pain is considered nontypical.