We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Contributions |

The Denial of Chest Pain in 32 Patients With Acute Myocardial Infarction

Harry S. Olin, MD; Thomas P. Hackett, MD
JAMA. 1964;190(11):977-981. doi:10.1001/jama.1964.03070240023006.
Text Size: A A A
Published online


Thirty-two patients with an acute myocardial infarction were investigated soon after they were hospitalized. The principal symptom of all but one was pain, which was severe in 27 and moderate in five. Despite the fact that most of the 32 patients were familiar with the symptoms of coronary disease, their first impulse was to explain away the pain by attributing it to other conditions less threatening than myocardial infarction. Even the nine patients who correctly diagnosed the cause of their pain did not take appropriate steps to obtain treatment. The patients' reaction was "it couldn't happen to me," an attitude which persisted long after they were admitted to the hospital. None complained to the investigator of being frightened or anxious and only one directly mentioned that he was worried about dying. Furthermore, none asked either for sedatives or for reassurance about his immediate future. The direct statements and hospital behavior of the 32 patients were consistent with their denial of death fear while serious cardiac symptoms were developing and throughout their hospital course.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.