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Chest pain and anxiety disorder

F J Kane1, E Wittels, R G Harper

  • 1Baylor College of Medicine, Houston, TX 77030.

Texas Medicine
|July 1, 1990
PubMed

Insights

Chest pain often signals inner stress, not just heart disease. Many patients with normal angiograms show high rates of anxiety and panic disorders, frequently undiagnosed and untreated.

Area of Science:

  • Cardiology
  • Psychiatry
  • Psychosomatic Medicine

Background:

  • Chest pain is a common symptom of coronary artery disease.
  • However, chest pain can also be a somatic manifestation of psychological stress.
  • This study investigates the prevalence of anxiety and panic disorders in patients presenting with chest pain and normal coronary angiograms.

Purpose of the Study:

  • To determine the frequency of generalized anxiety disorder, panic attacks, and panic disorder in patients with chest pain and normal coronary angiograms.
  • To highlight the underdiagnosis and undertreatment of stress-related disorders presenting as chest pain.
  • To provide guidance on identifying and managing these conditions.

Main Methods:

  • Retrospective analysis of patients undergoing coronary angiography between 1984 and 1985.
  • Survey of 570 patients with normal angiograms via questionnaires.
  • Analysis of questionnaire responses to diagnose anxiety and panic disorders.

Main Results:

  • A total of 371 patients (65%) responded to the questionnaire.
  • 26% of respondents met criteria for generalized anxiety disorder.
  • 43% of respondents met criteria for panic attacks or panic disorder.
  • Stress-related disorders were frequently diagnosed but rarely treated.

Conclusions:

  • A significant proportion of patients with chest pain and normal coronary angiograms suffer from anxiety and panic disorders.
  • These psychological conditions are often overlooked and undertreated, despite being a common cause of chest pain.
  • Improved diagnostic and treatment strategies are needed for stress-related chest pain.

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