Chest wall syndrome. A common cause of unexplained cardiac pain

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Abstract
Patients (12) with severe, often incapacitating chest pain initially believed to be cardiac in origin were shown on subsequent evaluation to have chest wall syndrome. Diagnosis was suspected by the atypical nature of pain in 11 of 12 patients and confirmed by chest wall tenderness simulating the spontaneously occurring pain in all. Chest wall syndrome was seen in conjunction with other associated cardiac conditions in 7 patients. Five patients had isolated chest wall syndrome, normal ejection fractions and no regional wall abnormalities on radionuclide cineangiographic studies performed during symptom-limited supine exercise, findings observed in few patients with coronary artery disease. Chest wall syndrome should be considered in all patients with chest pain as its recognition can greatly aid in patient care.