Chest pain and angiographically normal coronary arteries. Implications for treatment

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V Mukerji1, B D Beitman, M A Alpert

  • 1Department of Medicine, University of South Alabama College of Medicine, Mobile.

Texas Heart Institute Journal
|January 1, 1993
PubMed

Insights

Many patients with chest pain have normal coronary arteries but suffer disabling symptoms. Panic disorder is a common, treatable cause, significantly impacting quality of life.

Area of Science:

  • Cardiology
  • Psychiatry

Background:

  • Coronary arteriography reveals normal coronary arteries in 20-30% of patients evaluated for chest pain.
  • These patients often experience persistent, disabling chest pain despite a good survival rate.

Purpose of the Study:

  • To identify the most common underlying conditions in patients with chest pain and normal coronary arteries.
  • To highlight the impact of panic disorder on this patient group.

Main Methods:

  • Review of patients undergoing coronary arteriography for chest pain evaluation.
  • Differential diagnosis including microvascular angina, esophageal dysfunction, fibromyalgia, and panic disorder.

Main Results:

  • Panic disorder is diagnosed in at least one-third of patients with chest pain and normal coronary arteries.
  • Panic disorder can co-exist with other conditions like microvascular angina.

Conclusions:

  • Accurate diagnosis and treatment of panic disorder are crucial for managing psychosocial morbidity in patients with chest pain and normal coronary arteries.
  • Addressing panic disorder can improve the quality of life for affected individuals.

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