Title: Panic attack and its correlation with acute coronary syndrome - more than just a diagnosis of exclusion
year: 2010
Journal: Ann Acad Med Singapore
Volume: 39
Issue: 3
Pages: 197-202
Epubdate: 08/04/2010
date: Mar
Alternate Journal: Annals of the Academy of Medicine, Singapore
ISSN: 0304-4602 (Print)
Accession Number: 20372755
Abstract: The panic attack is able to mimic the clinical presentation of an acute coronary syndrome (ACS), to the point of being clinically indistinguishable without appropriate investigations. However, the literature actually demonstrates that the 2 conditions are more related than just being differential diagnoses. Through a review of the literature involving epidemiological studies, randomised controlled trials, systematic reviews and meta-analyses found on a Medline search, the relation between panic disorder and ACS is explored in greater depth. Panic disorder, a psychiatric condition with recurrent panic attacks, has been found to be an independent risk factor for subsequent coronary events. This has prognostic bearing and higher mortality rates. Through activation of the sympathetic system by differing upstream mechanisms, the 2 conditions have similar presentations. Another psychiatric differential diagnosis would be that of akathisia, as an adverse effect to antidepressant medications. An overview on the investigations, diagnostic process, treatment modalities and prognoses of the two conditions is presented. Panic disorders remain under-diagnosed, but various interviews are shown to allow physicians without psychiatric training to accurately pick up the condition. Comprehensive multidisciplinary approaches are needed to help patients with both coronary heart disease and anxiety disorder.
URI: https://open-access.imh.com.sg/handle/123456789/4491
Authors Address: Department of Community Psychiatry
Institute of Mental Health
Database Provider: NLM
language: eng
Appears in Collections:2010

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