Panic & plaques: Panic disorder & coronary artery disease in patients with chest pain

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)114-126
Number of pages13
JournalJournal of the American Board of Family Practice
Volume17
Issue number2
StatePublished - Mar 2004

Fingerprint

Panic
Panic Disorder
Chest Pain
Coronary Artery Disease
Medical Subject Headings
Confidence Intervals
Somatoform Disorders
Family Physicians
Bibliography
MEDLINE
Diagnostic and Statistical Manual of Mental Disorders
Coronary Disease
Case-Control Studies
Hospital Emergency Service
Cohort Studies

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

@article{5ef5ad7d62f84ee59dcacc280561d45c,
title = "Panic & plaques: Panic disorder & coronary artery disease in patients with chest pain",
abstract = "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.",
author = "Katerndahl, {David A}",
year = "2004",
month = "3",
language = "English (US)",
volume = "17",
pages = "114--126",
journal = "Journal of the American Board of Family Medicine",
issn = "1557-2625",
publisher = "American Board of Family Medicine",
number = "2",

}

TY - JOUR

T1 - Panic & plaques

T2 - Panic disorder & coronary artery disease in patients with chest pain

AU - Katerndahl, David A

PY - 2004/3

Y1 - 2004/3

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=3242889053&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3242889053&partnerID=8YFLogxK

M3 - Article

C2 - 15082670

AN - SCOPUS:3242889053

VL - 17

SP - 114

EP - 126

JO - Journal of the American Board of Family Medicine

JF - Journal of the American Board of Family Medicine

SN - 1557-2625

IS - 2

ER -