Related Experiment Videos
Panic disorder in patients with chest pain and angiographically normal coronary arteries
B D Beitman1, V Mukerji, J W Lamberti
1Department of Psychiatry, University of Missouri-Columbia.
Insights
Patients with chest pain and normal coronary arteries often have panic disorder. This psychiatric condition is treatable and should be considered in diagnosis for recurrent chest pain in patients with healthy heart vessels.
Area of Science:
- Cardiology
- Psychiatry
Background:
- Patients with normal coronary arteries frequently experience recurrent chest pain.
- This chest pain can lead to social and work dysfunction.
Purpose of the Study:
- To investigate the prevalence of panic disorder in patients with chest pain and angiographically normal coronary arteries.
Main Methods:
- Ninety-four subjects with normal coronary arteries underwent structured psychiatric interviews within 24 hours of cardiac catheterization.
- Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) criteria were used.
Main Results:
- 34% of patients (32 out of 94) met the criteria for current panic disorder.
- Panic disorder, microvascular angina, and esophageal disorders each may explain chest pain in approximately 25% of these patients.
Conclusions:
- Panic disorder is a common diagnosis in patients presenting with chest pain despite having normal coronary arteries.
- Considering panic disorder is crucial as it is a treatable condition.
Abstract:
Although patients with angiographically normal or near normal coronary arteries are at low risk for cardiac disease, several follow-up studies have shown that many continue to report recurrent chest pain associated with social and work dysfunction. Three diagnostic entities have been proposed to explain the morbidity of this group: microvascular angina, esophageal motility disorders and panic disorder. The purpose of this study was to test the hypothesis that panic disorder is found frequently in patients with chest pain who have normal epicardial vessels. Ninety-four subjects with angiographically normal coronary arteries were interviewed according to a structured psychiatric protocol within 24 hours of their catheterizations. Thirty-two (34%) fit Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) criteria for current panic disorder. Because panic disorder can be effectively treated, physicians should consider this diagnosis in this group of patients. Current research findings suggest that panic disorder, microvascular angina and esophageal disorders may each form the basis for chest pain in approximately 25% of these patients. Miscellaneous problems account for the other 25%.