Panic attack triggering myocardial ischemia documented by myocardial perfusion imaging study. A case report
Gastão Luiz Fonseca Soares-Filho1, Claudio Tinoco Mesquita, Evandro Tinoco Mesquita
1Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT - Translational Medicine (CNPq), Rio de Janeiro, Brazil. galufo@gmail.com.
International Archives of Medicine
|September 25, 2012
Summary
Panic attacks can trigger myocardial ischemia in patients with coronary artery disease. Carbon dioxide challenge tests may reveal this link, aiding cardiovascular disease risk assessment.
Area of Science:
- Cardiology
- Psychiatry
- Translational Medicine
Background:
- Chest pain in panic attacks is often misdiagnosed as benign.
- Panic disorder is an independent risk factor for cardiovascular diseases and myocardial infarction.
- Differentiating ischemic from non-ischemic chest pain is crucial.
Observation:
- A case study involving a patient experiencing a panic attack induced by 35% carbon dioxide inhalation.
- Myocardial ischemia was documented during the induced panic attack using myocardial perfusion imaging.
- This highlights the potential for panic attacks to precipitate acute cardiac events.
Findings:
- Panic attacks, a form of mental stress, can induce myocardial ischemia.
- Mechanisms include increased coronary vasomotor tone or sympathetic hyperactivity, leading to heightened myocardial oxygen demand.
- Coronary artery spasm is implicated in panic disorder-associated cardiac ischemia.
Implications:
- Mental stress testing, like the CO2 challenge, can be an alternative method for investigating myocardial ischemia.
- CO2 challenge combined with Sestamibi SPECT offers a translational approach to understanding the interplay between panic disorder and cardiovascular disease.
- This method can improve the application of research findings in clinical practice.
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