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Editor's Correspondence
April 27, 1998

Paroxysmal Tachycardia in a Patient Without Panic Disorder

Author Affiliations

Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

Arch Intern Med. 1998;158(8):929. doi:

In a recent article in the ARCHIVES, Lessmeier and colleagues1 describe a set of patients in whom paroxysmal supraventricular tachycardia was misdiagnosed as panic disorder. We wish to add a case report to further highlight the relevance of this problem in different medical and social settings.

A 55-year-old man was referred to our clinic for psychosomatic evaluation and treatment of a presumed anxiety disorder. For more than 7 years, he had apparently suffered from recurrent attacks of palpitations mainly in the neck, dyspnea, and chest pain, all of which lasted several minutes to 3 hours and then subsided spontaneously. Previous examinations by specialists of multiple disciplines, including otorhinolaryngology (because of neck pain during attacks), pneumology (because of dyspnea), cardiology (with the use of multiple resting electrocardiograms and 24-hour electrocardiograms), ergometry, echocardiography, and internal medicine (blood biochemistry and measurement of levels of 5-OH-indolacetic acid and vanillylmandelic acid), had failed to reveal an organic abnormality. Moreover, attempts to treat the patient with analgesics, relaxants, nitrates, and beta-stimulants had been unsuccessful.

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