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January 2011



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First Published Tuesday, 10 February 2009

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Each year, many people seek emergency treatment for unexplained chest pains. A thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden, indicates several common factors among those affected, including stress at work, anxiety, depression and a sedentary lifestyle.

Chest pain is a common reason for patients to seek emergency treatment. A considerable number of patients are diagnosed with unexplained chest pain, which means that the pain cannot be linked to biomedical factors such as heart disease, or some other illness. The patient group is significant in size but so far researchers have been unable to identify specific causes for unexplained chest pain.

Many suffer from recurring bouts of pain over several years, while the health care services are unable to find out what’s causing it,” says Registered nurse Annika Janson Fagring, the author of the thesis.

In her thesis, Annika Janson Fagring describes and analyses symptoms among patients with unexplained chest pain. The results show that most of them are middle-aged, and that over a third of those affected were born outside Sweden. The chest pain had a negative impact on the patients’ daily life in the form of tiredness, anxiety and fear of death.

The main difference between women and men with unexplained chest pain is that men were more likely to perceive their lives and jobs as being stressful, while women tended more to suffer from symptoms of depressions and anxiety,” says Annika Janson Fagring.

The patients, both men and women, experienced more symptoms of depression and anxiety, and work-related stress when compared with a reference group of people who were not suffering from heart disease. The male patients were more physically active in their spare time than the female patients, but compared with the reference group, both the men and the women with unexplained chest pain led a more sedentary lifestyle.

The thesis also looks at the development of symptoms and the prognosis for patients with unexplained chest pain over a period of time, compared with patients suffering from angina and patients who had suffered a heart attack. A register study revealed that from 1987 up until 2000, the number of patients with diagnosed unexplained chest pain increased, and then leveled out. The number of patients with angina increased up until 1994 and has since fallen, while the number of patients who have suffered heart attacks has fallen throughout the whole period examined.

There were fewer deaths among patients with unexplained chest pain a year after they became ill, compared with patients that became ill with angina or suffered heart attacks. Deaths among men a year after falling ill with unexplained chest pain were a third higher compared with men in the rest of the population, while women did not display any increased risk of death.

Annika Janson Fagring says that the thesis shows that it is important to improve knowledge and understanding of the symptoms experienced by patients with unexplained chest pain, in order to be able to offer more individualized care.

Janson Fagring A. Unexplained chest pain in men and women – symptom perception and outcome. Thesis presentation, Sahlgrenska Academy, University of Gothenburg 2009. [Abstract]

Heart Health

Johns Hopkins Health Alert

CPR to the Rescue

If you have a friend or loved one with coronary heart disease, you’ll want to know what to do in the event of sudden, cardiac arrest. A study reported in the journal The Lancet compares the benefits of mouth-to-mouth ventilation and chest compressions versus chest compressions alone and their findings may surprise you.

A heart attack typically occurs when a blood clot in a coronary artery completely blocks blood flow to a segment of the heart. When this blockage takes place, portions of the heart muscle are deprived of oxygen and become permanently damaged. Damage to the heart muscle can impair the ability of the heart to pump blood efficiently, which can lead to heart failure. The impaired blood flow can also damage the electrical system of the heart and lead to arrhythmias.

A study reported in The Lancet (Volume 369, page 920) found that victims of cardiac arrest (heart attack) stand a better chance of surviving if a bystander performs only chest compressions and forgoes mouth-to-mouth ventilation.

Japanese researchers found that of 4,068 adults who had a cardiac arrest outside the hospital, those who received chest compressions alone were twice as likely to survive with good brain function 30 days later as those who received standard CPR (22% vs. 10%).

The findings go against the long-held principles of CPR, which combine chest compressions and “rescue breaths.” But they also support what a number of experts have said for years: Mouth-to-mouth resuscitation does little for cardiac arrest victims and may actually dim their already low odds of survival.

What’s more, mouth-to-mouth ventilation is often a barrier to bystanders initiating CPR. Chest compressions are vital to keep blood flowing to and from the heart until medical help arrives; stopping to deliver rescue breaths may impede this blood flow.

Bottom line: Though these study results have spurred calls for revamped CPR recommendations, guidelines from the American Heart Association (AHA) still advise rescue breaths (two breaths after every 30 chest compressions) for all cardiac arrest victims. We advise that you follow the AHA recommendations.

Posted in Heart Health on January 30, 2009


British Heart Foundation – February is National Heart Month:


One Response to “Psychological Stress & Unexplained Chest Pain/Heart Health: CPR to the Rescue”

  1. quit smoking Says:

    Helpful information thanks. I added your blog on my favorite, will visit again.

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