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Prevalence of mitral valve prolapse in panic disorder: effect of echocardiographic criteria
Abstract:
Although several investigators have found a higher incidence of mitral valve prolapse (MVP) in patients with panic disorder (PD) and agoraphobia with panic attacks (AgP), there are now several conflicting reports. Discrepancy in the rate of echocardiographic diagnosis of MVP in PD/AgP may be due to different criteria used in evaluating the echocardiogram. In this study, 15 echocardiograms performed on patients with PD/AgP were evaluated by two separate expert echocardiographers. Each used his own standard criteria for diagnosing MVP. The first reader diagnosed MVP in 9 of 15 patients with PD/AgP while the second did not diagnose MVP in any of the 15 patients. This substantiates the belief that criteria variance strongly influences estimates of the prevalence of MVP among patients with PD/AgP.
Insights
Conflicting reports exist on mitral valve prolapse (MVP) in panic disorder (PD) patients. This study highlights how differing diagnostic criteria between echocardiographers significantly impact MVP prevalence estimates in PD/AgP.
Area of Science:
- Cardiology
- Psychiatry
- Medical Diagnostics
Background:
- Previous research suggests a link between mitral valve prolapse (MVP) and panic disorder (PD) with agoraphobia (AgP).
- However, reported incidences of MVP in PD/AgP patients vary significantly across studies.
Purpose of the Study:
- To investigate the impact of varying diagnostic criteria on the echocardiographic diagnosis of MVP in patients with PD/AgP.
- To explore the discrepancy in MVP prevalence rates reported in patients with panic disorder.
Main Methods:
- Fifteen echocardiograms from patients diagnosed with PD/AgP were independently reviewed by two expert echocardiographers.
- Each expert utilized their own established criteria for diagnosing MVP.
Main Results:
- The first echocardiographer diagnosed MVP in 9 out of 15 patients (60%).
- The second echocardiographer diagnosed MVP in 0 out of 15 patients (0%).
- This substantial difference underscores the influence of diagnostic criteria variance.
Conclusions:
- The variability in echocardiographic criteria used for diagnosing MVP significantly affects the estimated prevalence in patients with panic disorder and agoraphobia.
- Standardized diagnostic criteria are crucial for accurate MVP assessment in psychiatric populations.