Læknablaðið - 01.02.2018, Blaðsíða 17

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ENGLISH SUMMARY
Introduction: An estimated 50-75% of visits to cardiac emergency
departments are due to chest pain which is non-cardiac in nature
(non-cardiac chest pain (NCCP). This study evaluates the prevalence
of NCCP in the emergency departments at Landspitali, and assesses
its association with continued chest-pain post discharge, mental well-
being and the information-provision provided to NCCP patients during
hospitalization.
Material and methods: Participants were 390 patients (18-65 years)
presenting with chest pain to the cardiac emergency or the general
emergency department at Landspitali from October 2015-May 2016.
Measurements included questionnaires assessing somatic symptoms,
mental well-being and quality of life, and questions regarding continued
chest-pain and information-provision during hospitalization.
Results: In total 72% of participants (282) were considered having
NCCP while 24% (92) had cardiac disease. NCCP patients experienced
a similar burden of somatic and depressive symptoms, but slightly more
anxiety and mental distress than cardiac patients. Equal proportions
(60%) of NCCP and cardiac patients reported having experienced chest-
pain post discharge. Continued chest-pain was, however, associated
with greater anxiety (β=0.18, p<0.001) and depression (β=0.18, p<0.003)
among NCCP patients. Thirty percent of NCCP patients lacked instruct-
ions of how to respond to continued chest-pain and only 40% received
information regarding other possible causes of chest pain.
Conclusion: NCCP was prevalent among patients presenting to
emergency departments at Landspitali. The majority of NCCP pati-
ents experienced continued chest-pain after discharge, and such pain
experience was associated with mental distress. A third of NCCP pati-
ents lacked information about possible causes for the pain and advice
about coping with symptoms.
Non-cardiac chest pain and its association with persistent chest pain and poor mental well-being
Erla Svansdóttir1, Sesselja Hreggviðsdóttir2, Björg Sigurðardóttir3, Elísabet Benedikz1, Karl Andersen3,4, Hróbjartur Darri Karlsson5,6
1Department of Quality and Patient Safety, Landspítali University Hospital, Reykjavík IS-101 Iceland, 2Department of Psychology, University of Iceland, Reykjavík IS-101 Iceland,
3Landspítali University Hospital, Reykjavik IS-101 Iceland, 4School of Health Sciences, University of Iceland, Reykjavík IS-101 Iceland, 5Dunedin School of Medicine, Otago University,
Dunedin, New Zealand, 6Department of Cardiology, SDHB Dunedin Hospital, New Zealand.
Key words: non-cardiac chest pain, mental well-being, information-provision, pain experience, follow-up.
Correspondence: Erla Svansdóttir, erlasvan@landspitali.is