BACKGROUND: Many patients report chest pain of varying intensity at various locations during the first hours after percutaneous transluminal coronary angioplasty (PTCA). OBJECTIVES: The aim of the study was to increase knowledge regarding differentiating between harmless chest pain versus ischemic chest pain, focusing on patients description of their pain. METHODS: A total of 192 patients after elective PTCA were interviewed twice. In addition patients experiencing chest pain within 6 hours after the procedure completed the McGill Pain Questionnaire (MPQ). RESULTS: Nonspecific chest pain occurred in 34 patients (18%) and ischemic chest pain in 6 (3%), whereas 152 (79%) did not report early chest pain after PTCA. The nonspecific pain group reported statistically significant less pain intensity (VAS P =.001), used fewer (P =.006) and qualitatively weaker (P =.008) words compared to the ischemic pain group. No predisposing factors that could predict chest pain were identified. CONCLUSIONS: Discriminators appear to be the pain intensity and the word descriptors. MPQ combined with a VAS could be valuable clinical tools with regard to patients' description of pain.