Possible mechanisms linking panic disorder and cardiac syndromes

Abstract

Since chest pain can indicate coronary artery disease, pulmonary embolus and other severe physical illness, a prompt and careful diagnosis is important. It can also be due to panic disorder, an anxiety disorder with serious morbidity and mortality consequences. The diagnosis of panic is often not obvious to all clinicians, and panic can also occur co- morbidly with physical heart disease. More specifically, panic anxiety often includes an abrupt feeling of fear accompanied by symptoms such as breathlessness, palpitations, chest pain, and thus patient fear of a heart attack. This concern may further confound physicians. The association between panic disorder and coronary artery disease has been extensively studied in recent years and, although some studies have shown anxiety disorders coexisting or increasing the risk of heart disease, no causal hypothesis has been well established. The aim of this chapter is to present the various ways in which the scientific community has been investigating the relations of panic disorder with cardiac syndromes.