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Doctors don’t diagnose a cause for most cases of chest pain

If you have chest pain, any health professional would advise you to get to the doctor, stat.

No doctor's diagnosis for chest pain.

If you have chest pain, any health professional would advise you to get to the doctor, stat. That’s still important, but you may not get an answer about what’s happening once you’re in the office—and that could put your heart at risk down the line.

When researchers analyzed the electronic health records of over 172,000 adults from 223 general practitioner offices in the U.K., they discovered that 72 percent of chest pain cases presented to primary care doctors don’t receive a diagnosis.

That may be a problem, since the long-term chances of cardiovascular events was higher in the undiagnosed group than those whose chest pain received a non-coronary diagnosis initially, such as anxiety, gastrointestinal issues or musculoskeletal problems. In fact, the undiagnosed group was 95 percent more likely to have a heart event—like a heart attack within one year than the other group.

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The researchers also found that those who don’t get a diagnosis within six months usually don’t undergo diagnostic testing, and that presents significant risk for future heart problems, since potential problems can remain undetected. But even when patients had coronary heart disease ruled out by doctors, they still remained at increased risk of cardiovascular events, the study noted.

So what’s the answer? One option, the researchers believe, is preventive heart treatment for all patients with unattributed chest pain, even though only a small percentage go on to experience a cardiovascular event. Another option may be to target patient patients with unattributed chest pain to identify who is at greatest risk so they can go on to get further cardiac testing—as opposed to those who have other conditions like anxiety or muscle aches. That would cut down on the risks associated with preventively treating everyone.

While additional research needs to be done to identify which patients are at highest risk, increasing diagnostic testing for chest pain could decrease the risk of fatal and non-fatal cardiovascular events, the researchers say. And that could prevent more people from suffering heart attacks that could have been avoided.

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