Tag Archives: atypical chest pain

Introduction Atypical or non-anginal chest pain (ACP) is any chest pain that has no cardiac cause. ACP is a common clinical condition encountered in everyday cardiology practice and constitutes about half of the cases of chest pain presented to emergency departments.1-5 Figure 1. X-ray showing dropped shoulder syndrome in an 18-year-old woman The causes of this complaint are varied, and controversial aetiologies (musculoskeletal, neurological, psychological, mediastinal, pulmonary and gastrointestinal) have been suggested.3,4,6-9 ACP may result from cervical root compression, which can be confirmed by magnetic resonance imaging (MRI) findings

Findings on examination I looked at 75 consecutive referrals to a chest pain clinic; I noted the following distinguishing features. For angina: Predictable on exertion. Goes with rest. Rarely at rest. Same as previous proved ischaemic discomfort. Mechanical: Effected by movement or inspiration. Reproduced by movement, pressure or percussion on examination. Can last hours or days. Located to a specific structure or nerve root distribution. Could be severe and prolonged with normal electrocardiogram (ECG)/troponin. The most important finding on examination was reproduction of the symptoms by using passive movements of the cervical or thorac