It was with great interest that we read the article by Lessmeier et al1 describing patients with paroxysmal supraventricular tachycardia misdiagnosed as panic disorder. It is unfortunate that the dilemma continues, is it cardiac in origin or is it brain in origin, ie, panic disorder? Ballenger2 tried to place some restraint on the significance of these findings and cautioned against making too much of the result. Morris et al3 also reported on the high incidence of panic disorder in cardiac outpatients (12.5%), but also remarked that "it is often comorbid with heart disease." This last comment is most significant in our opinion, and is best illustrated by one of our recent cases.
McCrank E, Schurmans K, Lefcoe D. Paroxysmal Supraventricular Tachycardia Misdiagnosed as Panic Disorder. Arch Intern Med. 1998;158(3):297. doi: