Cardiac and psychiatric diagnoses among patients referred for chest pain and palpitations.
OBJECTIVE
The purpose of this study was to assess the prevalence of cardiac and psychiatric diagnoses in patients with chest pain and palpitations.


METHODS
Consecutive patients (n=198), aged between 18 and 65, referred to a cardiac outpatient unit for evaluation for chest pain or palpitations, were asked to participate. Patients with a previous history of heart disease, confirmed by a cardiologist, were excluded. The final sample comprised 160 patients. The cardiac evaluation comprised a bicycle stress test, myocardial scintigraphy, coronary angiography, or Holter monitoring. The psychiatric evaluation consisted of a diagnostic interview.


RESULTS
The prevalence of coronary heart disease was 4%. No cases of arrhythmia in need of treatment were detected. The prevalence of psychiatric disorders, among those without coronary heart disease, was 39%: 14% panic disorder, 14% somatoform disorders, and 5% major depression.


CONCLUSIONS
Cardiac conditions were rare, and the prevalence of panic and somatoform disorders was about three times higher than that of cardiac disease. The study illustrates the importance of having a strategy to identify psychiatric disorders in patients referred for chest pain or palpitations.
Department of Psychiatry, Molde Hospital, Molde, Norway. egil.jonsbu@helsenr.no
Egil
E
Jonsbu
Toril
T
Dammen
Gunnar
G
Morken
Arne
A
Lied
Harald
H
Vik-Mo
Egil W
EW
Martinsen
D000787:Angina Pectoris / Q000209:etiology; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D017023:Coronary Angiography; D003865:Major Depressive Disorder / Q000175:diagnosis; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D016584:Panic Disorder / Q000175:diagnosis; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D013001:Somatoform Disorders / Q000175:diagnosis