HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Katerndahl, D. Search for Related Content PubMed PubMed Citation Articles by Katerndahl, D.

Panic & Plaques: Panic Disorder & Coronary Artery Disease in Patients with Chest Pain

Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio

Correspondence: Address correspondence to David Katerndahl, MD, Division of Community Geriatrics, Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 (e-mail: katerndahl{at}uthscsa.edu)

Background: The purpose of this systematic review was to identify characteristics of the chest pain associated with the presence of panic disorder, to determine the strength of the association between panic disorder and coronary artery disease (CAD), and to determine the association between panic disorder and known cardiovascular risk factors.

Methods: Potential studies were identified via computerized search using MEDLINE and PSYCINFO databases, and review of bibliographies. MeSH headings used included "panic disorder" with "chest pain," "panic disorder" with "coronary disease or cardiovascular disorders or heart disorders," and "panic disorder" with "cholesterol or essential hypertension or tobacco smoking." Studies had to base their diagnosis of panic disorder on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, and objective criteria of CAD and risk factors had to be used. Only case-control and cohort studies were included.

Results: The relative risk of panic disorder in patients with nonanginal chest pain is 2.03 [confidence interval (CI), 1.41 to 2.92]. Concerning the relationship between panic disorder and CAD, studies conducted in emergency departments found a relative risk of 1.25 (CI, 0.87 to 1.80). However, there is an inverse relationship between the prevalence of CAD in the study and the prevalence of panic disorder among the patients with CAD (r = –.469, P = .086). Panic disorder has also been linked to cardiac risk factors.

Conclusions: Panic disorder and CAD are correlated in noncardiology settings, and recurrent panic attacks may actually cause CAD. Recognition of either condition should lead the family physician to consider the other, resulting in increased vigilance and possible screening.

This article has been cited by other articles:

				N. Frasure-Smith and F. Lesperance Depression and Anxiety as Predictors of 2-Year Cardiac Events in Patients With Stable Coronary Artery Disease Arch Gen Psychiatry, January 1, 2008; 65(1): 62 - 71. [Abstract] [Full Text] [PDF]

				J. W. Smoller, M. H. Pollack, S. Wassertheil-Smoller, R. D. Jackson, A. Oberman, N. D. Wong, and D. Sheps Panic Attacks and Risk of Incident Cardiovascular Events Among Postmenopausal Women in the Women's Health Initiative Observational Study Arch Gen Psychiatry, October 1, 2007; 64(10): 1153 - 1160. [Abstract] [Full Text] [PDF]