NONCARDIAC CHEST PAIN - WHY WAS A BRIEF INTERVENTION APPARENTLY INEFFECTIVE

Background. Patients who present with chest pain but have normal coron ary angiography and who are told by their cardiologist that they do no t have heart disease, have a poor symptomatic, psychological and quali ty of life outcome and remain concerned about a serious cause of their symptoms. They frequently complain they have not had enough informati on. The study aimed to test the effectiveness and acceptability of a b rief psychological intervention based on cognitive behavioural princip les. Methods. Consecutive patients with chest pain and normal angiogra ms were assessed and invited to take part in a randomized controlled e valuation. The intervention consisted of an individualized information and discussion session by a specially trained cardiac nurse, together with a handout and cassette providing information and advice and tele phone follow-up to discuss progress, answer questions and reiterate ad vice. Results. The treatment proved to be unacceptable to some patient s and there was no evidence of efficacy. Conclusions. Implications for the preparation of patients undergoing angiography and for the timing and delivery of information and advice following a negative result ar e discussed.