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September 1987

Atypical or Nonanginal Chest Pain: Panic Disorder or Coronary Artery Disease?

Author Affiliations

From the Departments of Psychiatry (Drs Beitman, Basha, DeRosear, and Trombka) and Medicine, the Division of Cardiology (Drs Flaker and Mukerji), University of Missouri, Columbia, and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Dr Katon).

Arch Intern Med. 1987;147(9):1548-1552. doi:10.1001/archinte.1987.00370090028005

• Of 195 patients with atypical or nonanginal chest pain presenting in a cardiology clinic, 104 consented to be evaluated for anxiety disorders using a structured psychiatric interview. Thirty patients had histories of coronary artery disease (CAD). Fifty-nine patients in the sample (16 of those with CAD and 43 of those without CAD) fit diagnostic criteria for panic disorder (PD). Those without CAD and with PD were primarily women (mean age, 43 years) with predominantly nonanginal chest pain. Those patients with both CAD and PD were primarily men (mean age, 54 years) with predominantly atypical angina. Since PD has been shown to be readily responsive to pharmacologic intervention, this diagnosis should be considered in patients with atypical or nonanginal chest pain.

(Arch Intern Med 1987;147:1548-1552)

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