[Chest pain due to a panic disorder: the significance of a multidisciplinary approach]

A 50-year-old man and a 76-year-old woman were presented with noncardiac chest pain at a medical-psychiatric unit, which is a dual medical and psychiatric inpatient unit in the University Hospital Maastricht, Tthe Netherlands. Since more than one year both patients had had complaints without a medical explanation for their symptoms. Somatic and psychiatric investigations were performed by a multidisciplinary team. Both patients were diagnosed with a panic disorder which has been shown to be highly treatable. Panic disorder induced noncardiac chest pain is a common problem that often remains unrecognized, due to the fact that patients primarily report somatic symptoms. The consequences are a high medical consumption and economic costs due to loss of working days. Moreover, anxiety may even increase cardiac morbidity and mortality directly. This stresses the importance of effective screening for psychopathology in this large group of patients. A multidisciplinary approach is advisable to motivate such patients for treatment, as they accept the presence of a psychiatrist in a combined clinic more readily.