Chest Pain with Normal Coronary Angiograms

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Abstract
Coronary angiograms are found to be normal in approximately 10 to 20 percent of patients undergoing cardiac catheterization to evaluate angina-like chest pain. Although their prognosis is good,1 most of these patients continue to experience chest pain despite reassurance that they do not have obstructive coronary disease; the pain results in continued hospitalizations, more cardiac catheterizations, and diminished quality of life and ability to work2. The mechanisms of pain in these patients, even those with ischemic-appearing electrocardiographic responses to exercise (sometimes referred to as syndrome X), continue to be controversial, as evidenced by numerous studies with often conflicting results, . . .