Absence of chest pain relief in patients diagnosed with minimal or absent coronary disease.

Patients with chest pain and minimal or no coronary disease have a good prognosis for survival, yet many continue to experience chest pain. We analyzed factors related to unimproved chest pain among 548 medically treated patients one year after undergoing angiography at Duke University Medical Center. Variables from the history and catheterization findings were entered in a stepwise logistic regression function with follow-up pain as the dependent variable. For an unbiased subset of 196 patients we entered behavioral variables including 4 MMPI scales and coronary prone behavior type. Hypochondriasis was the most significant predictor of continuing pain. While the etiology of pain in symptomatic patients with insignificant or absent coronary disease has yet to be determined, these findings indicate that an excess identification of personal somatic complaints is prospectively associated with continuing, unimproved pain.