The Anterior Chest Wall Syndrome—chest Pain Resembling Pain of Cardiac Origin

Chest wall syndrome among primary care patients: a cohort study

“…Nevertheless, tender points are only of diagnostic significance if they match the localization of spontaneous pain, which is mostly unilateral. The presence of a tender point is far from specific for the diagnosis of CWS, as it is frequently recorded in affections of other origins such as coronary heart disease [ 6 , 27 ], pulmonary embolism [ 28 ], pleuritic, neoplasic and psychogenic diseases. However, our community-based study goes against existing information, namely, that half of patients with angina pectoris have tender points [ 6 ], and that half patients with chest wall tenderness suffer from coronary heart disease [ 27 ].…”

“…The presence of a tender point is far from specific for the diagnosis of CWS, as it is frequently recorded in affections of other origins such as coronary heart disease [ 6 , 27 ], pulmonary embolism [ 28 ], pleuritic, neoplasic and psychogenic diseases. However, our community-based study goes against existing information, namely, that half of patients with angina pectoris have tender points [ 6 ], and that half patients with chest wall tenderness suffer from coronary heart disease [ 27 ]. The same consideration is probably valid in the case of the manoeuvres of provocation, even though their sensitivity and their specificity is also unknown [ 19 ].…”

“…Although potentially considered as one entity -the chest wall syndrome- clinicians often prefer individual terminology depending on points of maximum tenderness on the chest wall. Historically, these different syndromes have been described separately but have not been described together [ 6 - 17 ]. Furthermore, in practice, multiple names have been used to describe this syndrome such as costochondritis, anterior chest wall syndrome, atypical chest pain, musculoskeletal chest pain syndromes... probably reflecting the poor understanding of this condition [ 9 ].…”