Chronic Chest Pain Clinic



Dr. David Brown

The Chronic Chest Pain Clinic treats adults with challenging chronic chest pain syndromes that have not responded to conventional approaches including medications, coronary stenting or bypass surgery. For many individuals, chest pain (angina) of sudden onset is the primary symptom of a heart attack and is a medical emergency. But for other patients, chest pain can be a chronic, debilitating and frustrating disease that may be caused by spasm or dysfunction of the large or microscopic arteries of the heart or may not originate in the heart at all. The Chronic Chest Pain Clinic is staffed by doctors trained in heart and blood vessel conditions (cardiologists) in collaboration with specialists in gastrointestinal medicine, pain management and psychology. These specialists will work together to diagnose your condition and determine the most appropriate treatment for your condition.

You may be evaluated and treated in the Chronic Chest Pain Clinic if:

  • You have coronary artery disease or you have normal coronary arteries and experience chest pain at rest or with exertion.
  • You have had a previous heart attack, coronary angioplasty or stents, or coronary bypass surgery and continue to have chest pain despite medical management.
  • You have a complex cardiac history or known coronary artery disease and no longer can be treated with conventional stenting or cardiac surgery.
  • You have survived a cardiac arrest without a cause being identified


Your evaluation in the Chronic Chest Pain Clinic may involve:

  • Comprehensive evaluation and testing. We will ask you to complete an extensive health history to pinpoint individual risk factors for heart disease and for other chest pain-related diseases before your office visit. During your visit a personalized evaluation will be tailored to your unique situation and may include blood tests and an electrocardiogram (ECG), chest X-ray, echocardiogram, CT scan, a coronary angiogram or stress testing using MRI and/or PET imaging.
  • Patient education. You will be counselled on how to make healthy lifestyle changes to help prevent or slow the progression of heart disease including blood pressure measurement and control, a personalized exercise prescription, a healthy eating plan, advice about how to stop smoking, and stress management techniques.
  • Treatment options. You may be treated with one or more medications, invasive procedures such as stent placement, surgery and other therapeutic options including spinal cord stimulation.


Washington University School of Medicine
Cardiovascular Division
1020 N. Mason Road, Suite 100
St. Louis MO 63141
Phone: 314-362-1291

Making an Appointment

Referring Physicians call: 314-362-1291
Patients call: 314-362-1291
or Toll Free Appointment Line: 888-210-8375