Unexplained chest pain in the ED: could it be panic?

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• 作者：Guillaume Foldes-Busque MPs^a ;   ; ^b ;   ; ^{guill.foldesbusque@videotron.ca} ; André ; Marchand PhD^a ;   ; ^c ; Jean-Marc Chauny MD^d ; Julien Poitras MD^b ;   ; ^e ; Jean Diodati MD^c ; Isabelle Denis MSc^a ; Marie-José ; e Lessard BSc^a ; Marie-È ; ve Pelland MPs^a ; Richard Fleet MD ; PhD^a ;   ; ^b ;   ; ^e
• 刊名：The American Journal of Emergency Medicine
• 出版年：2011
• 出版时间：September 2011
• 年：2011
• 卷：29
• 期：7
• 页码：743-751
• 全文大小：314 K

文摘

Purpose

This study aimed at (1) establishing the prevalence of paniclike anxiety in emergency department (ED) patients with unexplained chest pain (UCP); (2) describing and comparing the sociodemographic, medical, and psychiatric characteristics of UCP patients with and without paniclike anxiety; and (3) measuring the rate of identification of panic in this population.

Basic Procedure

A structured interview, the Anxiety Disorders Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, was administered to identify paniclike anxiety and evaluate patients' psychiatric status. Anxious and depressive symptoms were evaluated with self-report questionnaires. Medical information was extracted from patients' medical records.

Main Findings

The prevalence of paniclike anxiety was 44 % (95 % CI, 40 % -48 % ) in the sample (n = 771). Psychiatric disorders were more common in panic patients (63.4 % vs 20.1 % ), as were suicidal thoughts (21.3 % vs 11.3 % ). Emergency physician diagnosed only 7.4 % of panic cases.

Principal Conclusions

Paniclike anxiety is common in ED patients with UCP, and this condition is rarely diagnosed in this population.