Panic disorder and chest pain: A study of cardiac stress scintigraphy patients

Recurrent chest pain in the absence of coronary artery disease is a major public health problem. Despite the reassurance provided by objective measures of coronary vessel patency and an excellent cardiac prognosis, many patients continue to experience symptoms, social and occupational disability, and to seek frequent medical therapy.^1-4 Several studies have identified a high prevalence of panic disorder among patients with chest pain and normal coronary arteries.^5-7 In populations undergoing coronary angiography or treadmill testing, 30% to 50% of patients with negative results meet criteria for panic disorder.^5-7 The current study investigated the prevalence of panic and other psychiatric disorders in the nuclear medicine department in patients with chest pain referred for noninvasive evaluation by myocardial stress perfusion scintigraphy. We also assessed 2 self-report measures, the Zung anxiety scale,⁸ and the anxiety sensitivity index⁹ for their use as screens for panic disorder.