Timing continued:

• In patients with recurrent chest pain, duration is very important. Prolonged duration favors a non-cardiac source.
• Any patient with prolonged pain due to coronary disease, eg. MI or unstable angina, will usually seek help without delay.
• The duration of a half hour or more suggests that the source of Mrs. Mack's pain is not going to be the heart.
• In fact, clinical studies have shown that recurrent chest pain persisting for more than an hour clearly favors an esophageal source.
• Esophageal pain is often post-prandial, but in patients with angina, there may also be a tendency to develop their pain following a heavy meal.