A LONG-TERM FOLLOW-UP-STUDY OF PATIENTS WITH ISCHEMIC-HEART-DISEASE VERSUS PATIENTS WITH NONSPECIFIC CHEST PAIN

Ninety consecutive patients who were admitted to hospital with acute c hest pain were followed-up five years later. At the time of the origin al admission, all of the patients received a detailed physical and psy chiatric evaluation. Seventy-one patients were diagnosed as having isc haemic heart disease, and 19 were diagnosed as having nonspecific ches t pain. Patients with nonspecific pain were younger, consumed greater amounts of alcohol, smoked more than their organic counterparts, and w ere more likely to suffer from psychiatric disorder. The five-year ass essment was carried out using a self-report questionnaire. Of the orig inal 71 patients with ischaemic heart disease, 14 had died; 43 questio nnaires were returned, 80.2% of the original sample. Sixteen (84.9%) o f the patients with nonspecific pain were followed up; none had died. Both groups were predominantly male. The patients with nonspecific pai n still smoked more than the patients with ischaemic heart disease, an d they had significantly more symptoms of anxiety. The overall prevale nce of psychiatric morbidity remained high, however, in both groups. P atients who had psychiatric illness at the time of the original assess ment were more anxious at follow-up and more likely to complain of che st pain than those who had been well. Patients with nonspecific chest pain continued to seek treatment on a regular basis from their general practitioners either for chest pain or for other symptoms, but few we re in frequent contact with hospital services. The possible preventive effects of psychiatric intervention at an earlier stage in both group s of patients needs to be investigated.