Korean Journal of Family Medicine

"Chest Pain"

Original Article

Non-Coronary Patients with Severe Chest Pain Show More Irrational Beliefs Compared to Patients with Mild Pain: Mostafa Bahremand, Mozhgan Saeidi, Saeid Komasi; Korean J Fam Med 2015;36(4):180-185. Published online July 17, 2015; DOI: https://doi.org/10.4082/kjfm.2015.36.4.180

Abstract
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Background

Despite providing insufficient medical evidence of the existence of a real cardiac condition, patients with non-coronary chest pain still interpret their pain incorrectly. The present study, therefore, sought to compare the irrational beliefs in non-coronary patients with mild chest pain against those with severe chest pain.

Methods

A cross-sectional design was used. The statistical population comprised non-coronary patients who presented to the Heart Emergency Center of Kermanshah city, Iran. Using a matching method, 96 participants were selected and studied in two groups of 48. The instruments used were the Comorbidity Index, Brief Pain Index, and the Jones Irrational Beliefs Test (short-form). The multivariate analysis of variance, chi-square test, and t-test were used for data analysis.

Results

Controlling for the effects of age and comorbid conditions, the severity of three types of irrational beliefs, including emotional irresponsibility (P<0.001), hopelessness changes (P<0.001), and problem avoiding (P=0.002) was higher among patients with severe chest pain (according to effect level). However, in terms of demand for approval, no difference was seen between the two groups (P=0.180).

Conclusion

Non-coronary patients with severe chest pain showed a greater number of irrational beliefs in comparison to patients with mild pain. Irrational beliefs are common mental occurrences in patients with non-coronary chest pain, and they should be attended to by health professionals, especially in severe non-coronary chest pain. Further investigation to determine the association between irrational beliefs and non-coronary chest pain is necessary.

Citations

Citations to this article as recorded by

Examining Irrational Beliefs and their Association with the Quality of Life of Students: Evidence from a Cross-Sectional Study
Ali Reza Yusefi, Omolbanin Atashbahar, Jamshid Bahmaei, Hedyeh Askarpour, Shima Bordbar
The Open Public Health Journal.2024;[Epub] CrossRef
Which symptoms are the psychopathological core affecting the manifestation of pseudo-cardiac symptoms and poor sleep quality in young adults? Symptoms of personality disorders versus clinical disorders
Mostafa Bahremand, Saeid Komasi
Frontiers in Psychology.2022;[Epub] CrossRef
Correlation of Heart Knowledge and Cardiac Risk Factors with Readiness for Lifestyle Modification in Companions of Patients with Cardiovascular Diseases in the West of Iran
Parvin Ezzati, Shayesteh Salehi
Middle East Journal of Rehabilitation and Health.2019;[Epub] CrossRef
Heart Knowledge and Risk Perception Profile in Substance Misusers: Partitioning Risky Samples and Determining Correlates: A Cross-Sectional Study
Mozhgan Saeidi, Mohammad Mahdi Amiri, Mona Azizi, Fyroozeh Dashti, Mostafa Alikhani, Ali Soroush, Saeid Komasi
Middle East Journal of Rehabilitation and Health Studies.2019;[Epub] CrossRef
Barriers for the Referral to Outpatient Cardiac Rehabilitation: A Predictive Model Including Actual and Perceived Risk Factors and Perceived Control
Ali Soroush, Behzad Heydarpour, Saeid Komasi, Mozhgan Saeidi, Parvin Ezzati
Annals of Cardiac Anaesthesia.2018; 21(3): 249. CrossRef
Triggers of Substance Abuse Slip and Relapse During Outpatient Treatment in Methadone/Buprenorphine Maintenance Therapy Clinics: A Predictive Model with Emphasis on Treatment-Related Factors
Saeid Komasi, Mozhgan Saeidi, Mohammad Mehdi Amiri, Nasrin Nazeie, Nasim Shams Alizadeh, Ali Soroush
Jundishapur Journal of Health Sciences.2017;[Epub] CrossRef
Comparison of Depression, Anxiety, and Stress Between Mild and Severe Non-cardiac Chest Pain
Mostafa Bahremand, Mozhgan Saeidi, Fariba Takallo, Saeid Komasi
Thrita.2016;[Epub] CrossRef
Cognitive Restructuring Based on Metaphor Therapy to Challenge the Irrational Beliefs of Drug Addicts Undergoing Buprenorphine Treatment
Saeid Komasi, Mozhgan Saeidi, Ali Zakiei, Mohammad Mehdi Amiri, Bahareh Soltani
International Journal of High Risk Behaviors and Addiction.2016;[Epub] CrossRef
Irrational beliefs predict pain/discomfort and emotional distress as a result of pain in patients with non-cardiac chest pain
Saeid Komasi, Ali Soroush, Mostafa Bahremand, Mozhgan Saeidi
The Korean Journal of Pain.2016; 29(4): 277. CrossRef
Non-coronary chest pain does not affect long-term mortality: a prospective, observational study using a matched population control
Staffan Nilsson, Petter Järemo
BMC Family Practice.2016;[Epub] CrossRef
Comments on Statistical Issues in September 2015
Kyung Do Han, Yong Gyu Park
Korean Journal of Family Medicine.2015; 36(5): 258. CrossRef

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11 Crossref

Case Report

A Case of Acute Aortic Dissection Presenting with Chest Pain Relieved by Sublingual Nitroglycerin: Hyun Joo Kim, Hyun-Ki Lee, Belong Cho; Korean J Fam Med 2013;34(6):429-433. Published online November 25, 2013; DOI: https://doi.org/10.4082/kjfm.2013.34.6.429

Abstract
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Acute aortic dissection is an uncommon disorder which can have fatal results in the event of treatment delay or misdiagnosis. This case examines a 77-year-old woman presenting with chest pain relieved by nitroglycerin. She was referred to the emergency room with clinical suspicion of acute coronary syndrome (ACS). However, she was later diagnosed with acute aortic dissection and an emergency operation was performed with successful recovery. Aortic dissection may manifest in various ways depending on the site involved and may mimic other disorders such as ACS or pulmonary embolism. Therefore, clinicians must always be aware of aortic dissection and its different clinical manifestations must be understood.

Citations

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Saif Al‑Mudhaffar, Ala Alwan, Rafid Ouj, Abdullah Mowaffaq, Fahmi Kakamad, Okba Ahmad, Dana Mohammed‑Saeed, Razhan Ali, Berun Abdalla, Shvan Mohammed, Abdulwahid Salih
Medicine International.2023;[Epub] CrossRef
ANATOMY OF AORTIC DISSECTION IN THE PATIENT WITH MARFAN SYNDROME WHO UNDERWENT SURGERY: A CASE REPORT
Uliana Pidvalna, Dmytro Beshley, Lesya Mateshuk-Vatseba, Vitaliy Averchuk, Liubomyr Kulyk
Proceedings of the Shevchenko Scientific Society. Medical Sciences.2020;[Epub] CrossRef
Impact of Visual Thinking Strategies (VTS) on the Analysis of Clinical Images: A Pre-Post Study of VTS in First-Year Medical Students
Gauri G. Agarwal, Meaghan McNulty, Katerina M. Santiago, Hope Torrents, Alberto J. Caban-Martinez
Journal of Medical Humanities.2020; 41(4): 561. CrossRef
Acute aortic dissection overlapping with herniated discs in thoracic and lumbosacral spine
Rada Vučić, Stefan Simović, Mladen Kočica, Vladimir Miloradović, Ivan Simić, Olivera Andrejić
Srce i krvni sudovi.2017; 36(4): 250. CrossRef

6,126 View
40 Download
4 Crossref

Original Articles

Lifestyles and Gastrointestinal Disorders in Those Who Have a Postprandial Lying-down Habit.: Yong Min Ko, Jae Ho Lee, Joon Sik Seo, Joon Young Yoo, Kyu Suck Kang, Yong Chul Kim; J Korean Acad Fam Med 2004;25(12):887-894. Published online December 10, 2004

Abstract
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Background
: A habit of lying-down after eating is known as a risk factor of reflux esophagitis. However the association between gastrointestinal disorders and a postprandial lying-down habit has not yet been identified. Some people believe that lying-down after meals is helpful for their health. We intended to investigate the relationship between such a habit and the health lifestyles, gastrointestinal symptoms, disorders using a questionnaires and gastrofiberscopic results of patients who visited our general health screening center.

Methods : We examined 1,030 subjects (the frequent postprandial lying-down group was 576 persons (57.7%), the rare group was 436 persons (42.3%) who visited our general health screening center for a routine check-up including a gastrofiberoscopy during the period between January 2001 to December 2002. After frequency matching by age and sex, health lifestyles (such as smoking, alcohol consumption, exercise, eating habits, night time sleep duration and awakening frequency, nap, and coffee intake), gastrointestinal symptoms (dyspepsia, epigastric pain, heart burn, chest pain, and constipation) and gastrofiberoscopic findings were compared using results from the questionnaires and gastrofiberscopic findings. Factors such as gastritis and reflux esophagitis were set as dependent variables, while postprandial lying-down was set as an independent variable. The frequent postprandial lying-down group and the rare group were analysed through stepwised multiple logistic regression analysis.

Results : Subjects with a frequent postprandial lying- down habit showed a significantly greater degree in alcohol consumption (P=0.010), irregular eating habits (P＜0.001), eating between meals (P＜0.001), napping (P＜0.001), and night time awakening frequency (P= 0.016) than the rare group did. In addition, chest pain (P=0.031) and constipation (P=0.010) were more common in the frequent postprandial lying-down group. However, prevalence of dyspepsia (P=0.147), epigastric pain (P=0.085), and heartburn (P=0.700) showed no differences between the two groups. Being controlled with age, sex, education level, body mass index, and life style factors, postprandial lying-down group showed higher prevalence ratios in erythematous gastritis (OR 1.59; P=0.090), atrophic gastritis (OR 1.71; P= 0.059), and reflux esophagitis (OR 1.78; P=0.103).

Conclusion : A postprandial lying-down habit is associated with undesirable lifestyles and some gastrointestinal disorders. Therefore, a modification of the postprandial lying-down habit should be recommended. Further investigation is needed to clarify the causal relationships between a postprandial lying down habit and gastrointestinal symptoms and disorders.

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The Causes and Symptoms of Chest Pain among Young Policemen.: Young Kyo Choi, Sung Mo Baek, Yong In Son, Dong Hoon Shin; J Korean Acad Fam Med 2002;23(11):1369-1376. Published online November 10, 2002

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Causes and characteristics of the chest pain(in the chest-pain clinic).: Yong Sun Choi, Hye Sook Suh, Young Hoon Yoo, Hyung Soo Kim, Mee Young Kim, Jong Lull Yoon; J Korean Acad Fam Med 2001;22(10):1476-1483. Published online October 1, 2001

Abstract
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Background
: Ischemic heart disease is the most important cause of the chest pain, and its frequency is increasing enormously. The purpose of this study is to find out the way of early detection and/or ruling out the cardiogenic chest pain by history taking.

Methods : From July 1996 to December 1999, 248 patients visited the chest-pain clinic and took the questionnaire about characteristics of the chest pain. And we found out the diagnosis that caused the chest pain. 46 patients of them were excluded because of the unreliable responses or uncertain diagnosis. So, we compared the characteristics of the chest pain with causes for 202 patients.

Results : The sex ratio of patients was 1.43:1(male:female). The average age was 41.8±14.0 for male and 47.3±14.8 for female. The causes of the chest pain were cardiogenic(23.2%), musculoskeletal(19.3%), psychogenic(14.8%), gastrointestinal(12.4%), and pulmonary disease(6.9%), patients with the past history of diabetes, hypertension, alcohol intake, or angina were more likely to have cardiac disease. Choking (O.R=2.19, C.I=1.08-4.44), splitting(O.R=3.38, C.I=1.24-9.21), or exploding pain (O.R=2.65, C.I=1.02-6.88) was more likely to be originated from cardiac disease. And patients with cardiogenic chest pain aggravated their symptoms by climbing the stairs (O.R=3.47, C.I=1.52-7.90). But, pricking pain(O.R=0.18, C.I=0.04-0.82) or chest pain associated with dyspepsia(O.R=0.16, C.I=0.04-069) was less likely to be originated from cardiac disease.

Conclusion : For detection and/or ruling out the cardiogenic chest pain, we have to check out characteristics of the pain, but also factors that associated with the pain or aggravating the pain.

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The relation between psychosocial factor of inorganic chest pain and neurotic symptoms.: Hyoung Don Jue, Hwan Seok Lee, Nan Young Kim, Dong Hyun Eem, Chang Ho Yeon, Jung Bum Lee; J Korean Acad Fam Med 2000;21(9):1150-1156. Published online September 1, 2000

Abstract
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Background
: Compared to Europe and America neurotic chest pain patients seems to be much more prevalent in Korea. This study was designed to depict various neurotic symptoms of patients with inorganic chest pain.

Methods : In the course of one year(from March, 1997 to March, 1998), 70 subjects were selected among the people who visited the outpatient clinic of department of family medicine with symptom of chest pain. The control group was selected from a healthy population which matched nearly the same number as the chest pain group. Patients were tested by EKG, treadmill, chest X-ray, 2D-UCG and requested to answer SCL-MPD questionnaire. Statistical analysis by means of SPCC/PC + and for significance using non-parametric Mann-Whitney U teat was done.
Result : The chest pain group scored significantly higher than the control group in obsessive and compulsive, anger-hostility, depression, anxiety and somatization scale. Male chest pain group scored higher in somatization, anxiety, obsessive- compulsive, hypochondriasis, and depression scale. The female chest pain group scored higher in depression scale.

Conclusion : Many inorganic chest pain patients complain through various neurotic symptoms. When approaching chest pain patients we should consider the possibility of a psychosocial cause.

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Psychogenic symptoms in patients with noncardiac chest pain.: Young Ho Chang, Ji Ho Choi, Sang Hyun Lee, In Ho Kwak, Sun Duk Lee; J Korean Acad Fam Med 1999;20(12):1784-1793. Published online December 1, 1999

Abstract
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Background
: Patients with chest pain are common among outpatients. Several researches shows that chest pain patients can suffer from psychiatric illnesses such as hypochondriasis, depression, anxiety, somatization, panic disorder and so on. This study aims to examine the psychogenic symptoms in patients with noncardiac chest pain.

Methods : In this study, the 98 people who have undergone treadmill test for chest pain during the three months from June 1st to September 30 of 1998 were selected, and the 98 patients were asked to respond to the prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) before they underwent treadmill test. And then, they were classified into two groups. One group consisted of patients with noncardiac chest pain, and the other group of patients with cardiac chest pain. These two groups were compared in 19 measures, and the compared results were analyzed by t-test.

Results : Among the 25 patients with cardiac chest pain, 15 patients were males and 10 patients (33%) were females, and among the 44 patients with noncardiac chest pain, 31 patients(70%) were males, 13 patients (30%) were females. The average age was 47 years old. The average age in patients with noncardiac chest pain was 48, and the 46 for those patients with cardiac chest pain. In the statistical analysis between the patients with cardiac chest pain and those with noncardiac chest pain, significant difference(p<0.005) was shown in the measures such as somatization, depression, phobic anxiety, obsessive-compulsive, neurasthenic, hypochodrial, anxiety, anger-hostility, interpersonal sensitivity.

Conclusion : As in the analysis the patients with noncardiac chest pain showed significant difference in the symptom check list minor psychiatric disorder compared to those with cardiac chest pain. We conclude that primary care physician should take more interest in evaluating psychiatric symptoms in patients with noncardiac chest pain.( J Korean Acad Fam Med 1999;20:1784-1793)