[Myocardial infarct, functional heart symptoms and panic syndrome]

Cardiovascular manifestations of anxiety have long been known. A particularly intriguing problem even today is the differentiation between real and false "heart attacks". We compared 20 patients with functional cardiac complaints and 20 patients with myocardial infarction with respect to their "heart attacks" and psychological disorders. In spite of methodological problems our results indicate much more dramatic symptoms in the functional group. Their localization of "cardiac" pain resembled the generally accepted picture for myocardial infarction much more than that of the patients with an actual infarction. Functional patients showed more help seeking behavior and were less able to describe triggers for their attacks than patients with myocardial infarction. Functional patients largely met DSM-III-R diagnostic criteria for panic disorder and had a higher prevalence of other psychological disorders.