While positive outcomes with drugs and treatments require prompt intervention, ideally at the first sign of distress, about one-third of women do not experience chest pain when having a heart attack.
In older age groups, men are affected more often and the disease is often misdiagnosed. Triggers include medications such as antibiotics, beta-blockers, and statins.
Among the most frequently prescribed medications, PPIs are associated with an increased risk of fracture, Clostridium difficile infection, community-acquired pneumonia, and vitamin and mineral deficiencies.
A prior history of anxiety, depression, and physical and psychological trauma is significantly predictive of onset of chronic pain in later life. The risk of central sensitization should not be underestimated.