Case Report A 37-year-old lady presented with a 6-month history of left-sided acute onset moderate to severe chest pain. [indianjpain.org]

Angina pectoris presenting as headache. Garg A, Bohra P, Gupta MK. Garg A, et al. Indian Heart J. 2004 Nov-Dec;56(6):685-6. Indian Heart J. 2004. PMID: 15754433 No abstract available. [pubmed.ncbi.nlm.nih.gov]

In addition, elderly individuals have a greater prevalence of coronary artery disease, which, when present, is more severe than that in younger patients 10. [scielo.br]

• Pain

  Non-cardiac chest pain: time to extend the rapid access chest pain clinic? Int J Clin Pract 2013;67:303–6. 16 Marks E, Chambers J, Russell V, et al. Rapid access chest pain clinic: distress and disability. [intramed.net]

  As the pain was not relieved by the medication, she decided to take an orthopedic consultation. The pain did not radiate to the arms, neck or abdomen. But she had occasional pain in her left shoulder. [indianjpain.org]

  Difficult problems in the diagnosis of chest pain. Levine HJ. Levine HJ. Am Heart J. 1980 Jul;100(1):108-18. doi: 10.1016/0002-8703(80)90286-0. Am Heart J. 1980. PMID: 6770665 Review. No abstract available. Evaluation of acute chest pain. [pubmed.ncbi.nlm.nih.gov]

  A sharp or ill-characterized chest pain or discomfort, not related to effort, was considered nonanginal chest pain 5. [scielo.br]

• Asymptomatic

  However, no statistically significant difference was found in the frequency of positive tests among asymptomatic patients and those with nonanginal chest pain [10% versus 16% (P=0.49)]. [scielo.br]

• Constitutional Symptom

  She had no history of fever, trauma or any other constitutional symptom in recent past. There was no history of similar illness in her family or history of major illness. Examination revealed an alert healthy female with normal vitals. [indianjpain.org]

• Dyspnea

  Clinician gestalt estimate of pretest probability for acute coronary syndrome and pulmonary embolism in patients with chest pain and dyspnea. Ann Emerg Med 2014;63:275–80. 23 Chambers J, Bass C. [intramed.net]

• Chest Pain

  Non-cardiac chest pain: time to extend the rapid access chest pain clinic? Int J Clin Pract 2013;67:303–6. 16 Marks E, Chambers J, Russell V, et al. Rapid access chest pain clinic: distress and disability. [intramed.net]

  Difficult problems in the diagnosis of chest pain. Levine HJ. Levine HJ. Am Heart J. 1980 Jul;100(1):108-18. doi: 10.1016/0002-8703(80)90286-0. Am Heart J. 1980. PMID: 6770665 Review. No abstract available. Evaluation of acute chest pain. [pubmed.ncbi.nlm.nih.gov]

  An unusual cause of chest pain: Fused cervical vertebra (C3-C4). [indianjpain.org]

  A sharp or ill-characterized chest pain or discomfort, not related to effort, was considered nonanginal chest pain 5. [scielo.br]

  Often chest pain is not associated with diseases of the heart. [survincity.com]

• Heart Disease

  Often chest pain is not associated with diseases of the heart. [survincity.com]

  Am Heart J. 1963 Sep;66:296-300. doi: 10.1016/0002-8703(63)90259-x. Am Heart J. 1963. PMID: 14056777 No abstract available. The second heart sound: a screening test for heart disease. Adolph RJ, Fowler NO. Adolph RJ, et al. [pubmed.ncbi.nlm.nih.gov]

  Discussion The syndromes of cardiovascular dysfunction caused by the autonomic dysfunction while without heart organic disease are named CAD [ 6, 7 ]. [alliedacademies.org]

  Chest pain on questionnaire and prediction of major ischaemic heart disease events in men. Eur Heart J 1998;19:63–73. 5 Locke GR, Talley NJ, Fett SL, et al. [intramed.net]

  Trends in nonfatal coronary heart disease in the United States, 1980 through 1989. Arch Intern Med 1993;153:2489-94. [ Links ] 2. Elveback LE, Lie JT. Continued high incidence of coronary artery disease at autopsy in Olmsted County. [scielo.br]

• Lordosis

  X-ray of cervical spine was done which showed presence of fused 3 rd and 4 th cervical vertebra with obliteration of cervical lordosis [Figure 1] and [Figure 2]. [indianjpain.org]

• Fear

  Those who are in fear of running to the doctor, believing that he had "a heart" and return home comforted: pain associated only with the muscles. [survincity.com]

  Treatment methods The main treatment was psychotherapy, aiming to eliminate the patient's fear and pressure. [alliedacademies.org]

  In addition, psychological factors, such as fear, anxiety, and lack of motivation, may interfere with test performance and even with safety 12. Due to these comorbidities, exercise testing may be neglected by clinicians. [scielo.br]

• Sciatica

  If the chest pain is changed by tilting and turning the body, taking a deep breath exhale sludge, moving the arms and nitroglycerin or validola virtually no effect on the rate, then it is probably due to sciatica or breast diseases rib cartilage. [survincity.com]

• Stroke

  However, in a very old population (75 years or more), diseases, such as osteo-articular disorders, previous stroke, chronic obstructive pulmonary disease, and peripheral vasculopathy, frequently coexisting with coronary artery disease, limit the capacity [scielo.br]

Treatment methods The main treatment was psychotherapy, aiming to eliminate the patient's fear and pressure. [alliedacademies.org]

A multidisciplinary, biopsychosocial treatment for non-cardiac chest pain. Int J Clin Pract Published Online First: 31 Oct 2014; doi:10.1111/ijcp.12533 21 Clare A, Andiappan M, MacNeil S, et al. [intramed.net]

[New data in the diagnosis and treatment of stable angina pectoris]. Kárpáti P. Kárpáti P. Orv Hetil. 2006 May 21;147(20):917-23. Orv Hetil. 2006. PMID: 16776046 Review. Hungarian. MeSH terms [pubmed.ncbi.nlm.nih.gov]

Why heartache Pain in the heart — One of the most frequent causes of treatment for people by ambulance. [survincity.com]

Exercise testing has a good cost-risk-benefit ratio for diagnosis and prognosis of coronary artery disease, including in the elderly population 11. [scielo.br]

Prognosis of incident angina and non-cardiac chest pain in 8762 consecutive patients. Heart 2007;93:458–63. 12 Blatchford O, Capewell S. [intramed.net]

Chest pain with normal coronary anatomy: a review of natural history and possible etiologic factors. Prog Cardiovasc Dis 1990;33:161–84. 24 Robertson N, Javed N, Samani NJ, et al. [intramed.net]

Noncardiac chest pain: epidemiology, natural course and pathogenesis. J Neurgastroenterol Motil 2011;17:110–23. 2 Eslick GD, Coulshed DS, Talley N. Review article: the burden of illness of non-cardiac chest pain. [intramed.net]

The pathophysiology of cardiac syndrome X—a tale of paradigm shifts. Cardiovasc Res 2001;52:174–7. 40 Parsyan A, Pilote L. Cardiac syndrome X: mystery continues. Can J Cardiol 2012;28:S30S6. 41 Rosen SD. [intramed.net]