Chest wall syndrome. A common cause of unexplained cardiac pain
S. E. Epstein, L. H. Gerber and J. S. Borer
Twelve patients with severe, often incapacitating chest pain initially
believed to be cardiac in origin were shown on subsequent evaluation to
have chest wall syndrome. Diagnosis was suspected by the atypical nature of
pain in 11 of 12 patients and confirmed by chest wall tenderness simulating
the spontaneously occurring pain in all. Seven patients had chest wall
syndrome in conjunction with other associated cardiac conditions. Five
patients had isolated chest wall syndrome. All five had normal ejection
fractions and no regional wall abnormalities on radionuclide
cineangiographic studies performed during symptom-limited supine exercise,
findings observed in few patients with coronary artery disease. Chest wall
syndrome should be considered in all patients with chest pain, as its
recognition can greatly aid in patient care.
