Atypical chest pain. Differentiation from coronary artery disease.

Atypical pain in the chest accounts for many visits to physicians. Possible sources of the pain include the pericardium, the pulmonary system, the aorta, the gastrointestinal tract, the chest wall, the mitral apparatus, and psychogenic factors. Identifying the source primarily involves taking an accurate history and understanding the prevalence of coronary artery disease in various patient populations. Electrocardiography chest films, and stress testing may help identify the source of pain. Cardiac catheterization should be reserved for patients with abnormal findings on non-invasive tests, those with unclear test results, and, rarely, as reassurance for patients with frequent episodes of atypical chest pain or their caregivers.