What Is the Long-Term Prognosis of Undiagnosed New Chest Pain?

In an effort to determine long-term outcomes for patients in whom causes for new-onset chest pain were not established initially, U.K. researchers examined records of 172,000 patients (mean age, 49) with no previous record of cardiovascular (CV) disease who presented with first episodes of chest pain between 2002 and 2008. At first presentation, chest pain was attributed to angina in 5% of patients and to noncoronary causes (e.g., esophageal reflux) in 23%; it was undiagnosed in 72% of patients. Of the 115,000 patients with undiagnosed chest pain who were followed for 6 months, 110,000 remained without CV diagnoses.

During the next 5 years of follow-up, risk for myocardial infarction (MI) was significantly higher in those whose chest pain re…