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Distinguishing Cardiac from Psychological Somatic Symptoms

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Brain and Heart Dynamics

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Abstract

Chest pain is not always a matter of serious concern. It is not necessarily life-threatening as it recognizes multiple potential benign causes. However, it is often followed by psychogenic symptoms that may interfere with the diagnostic process and the therapeutic approach. A reciprocal relationship between cardiac symptoms and psychopathology has long been described. Once heart-related causes have been ruled out, physicians refer to cardialgic syndrome as non-cardiac chest pain (NCCP). Currently it is commonly described as the occurrence of chest pain, generally associated with other neurovegetative symptoms, in the absence of ischemia signs on functional noninvasive testing or obstructive lesions/abnormalities at coronary angiography. Thus, this clinical diagnosis should be posed only after a careful clinical and instrumental assessment aimed at excluding any possible underlying cardiovascular factor. Clearly, to successfully perform this diagnostic pathway strictly depends on the willingness of a physician to investigate and on the setting where she works. In order to facilitate the differential diagnosis, all possible causes of the pain, their risk factors, and their prognosis should be previously considered so that the best decision for the patient can be made. This chapter focuses on the differential diagnosis of NCCP mainly dwelling upon thoracic manifestations of psychogenic origin.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy

    Alessandro Rodolico & Ludovico Mineo

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  1. Alessandro Rodolico
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  2. Ludovico Mineo
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Correspondence to Alessandro Rodolico .

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Editors and Affiliations

  1. Dept of Drug Sciences, Pharmacology Sect, University of Pavia, Dept of Drug Sciences, Pharmacology Sect, Pavia, Pavia, Italy

    Stefano Govoni

  2. Dept of Brain and Behavioural Sciences, University of Pavia Dept of Brain and Behavioural Sciences, Pavia, Pavia, Italy

    Pierluigi Politi

  3. Department of Molecular Medicine, University of Pavia, Department of Molecular Medicine, Pavia, Pavia, Italy

    Emilio Vanoli

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  1. Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy

    Laura Fusar-Poli

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Rodolico, A., Mineo, L. (2019). Distinguishing Cardiac from Psychological Somatic Symptoms. In: Govoni, S., Politi, P., Vanoli, E. (eds) Brain and Heart Dynamics. Springer, Cham. https://doi.org/10.1007/978-3-319-90305-7_16-1

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