Chest pain, cardiac disease, and panic disorder

Chest pain is one of the most frequent symptoms prompting presentation to a medical clinic. In primary care, more than 80% of patients are found to have no organic etiology for chest pain. Even among selected patients referred for coronary arteriography, 10% to 30% have little or no evidence of coronary artery disease. Recent studies suggest that panic disorder is a common cause of chest pain in patients with negative cardiac test results. Panic disorder can also occur along with a chronic medical illness, such as coronary artery disease, and may lead to physiologic worsening of that illness with more frequent episodes of chest pain.