title: Myocardial perfusion imaging study of CO(2)-induced panic attack.
abstract: Chest pain is often seen alongside with panic attacks. Moreover, panic disorder has been suggested as a risk factor for cardiovascular disease and even a trigger for acute coronary syndrome. Patients with coronary artery disease may have myocardial ischemia in response to mental stress, in which panic attack is a strong component, by an increase in coronary vasomotor tone or sympathetic hyperactivity setting off an increase in myocardial oxygen consumption. Indeed, coronary artery spasm was presumed to be present in cases of cardiac ischemia linked to panic disorder. These findings correlating panic disorder with coronary artery disease lead us to raise questions about the favorable prognosis of chest pain in panic attack. To investigate whether myocardial ischemia is the genesis of chest pain in panic attacks, we developed a myocardial perfusion study through research by myocardial scintigraphy in patients with panic attacks induced in the laboratory by inhalation of 35% carbon dioxide. In conclusion, from the data obtained, some hypotheses are discussed from the viewpoint of endothelial dysfunction and microvascular disease present in mental stress response.
authors.affiliation: Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT-Translational Medicine (CNPq), Rio de Janeiro, Brazil; Medical School, Department of Psychiatry, Severino Sombra University, Vassouras, Rio de Janeiro, Brazil. Electronic address: galufo@gmail.com.
authors.forename: Gastão L F
authors.initials: GL
authors.lastname: Soares-Filho
authors.affiliation: Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT-Translational Medicine (CNPq), Rio de Janeiro, Brazil; Physical Activity Neuroscience, Physical Activity Postgraduate Program, Salgado de Oliveira University (UNIVERSO), Niterói, Rio de Janeiro, Brazil; Quiropraxia Program of Faculty of Health Sciences, Central University, Santiago, Chile.
authors.forename: Sergio
authors.initials: S
authors.lastname: Machado
authors.affiliation: Movement Disorders and Transcranial Magnetic Stimulation Unit, Hospital General Dr. Manuel Gea González, Secretaría de Salud, México DF, México.
authors.forename: Oscar
authors.initials: O
authors.lastname: Arias-Carrión
authors.affiliation: Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Naples, Italy; Columbia University Medical Center, New York, New York.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Santulli
authors.affiliation: Department of Nuclear Medicine, Pró-Cardíaco Hospital/PROCEP, Rio de Janeiro, Brazil; Cardiology Department, Federal Fluminense University, Rio de Janeiro, Brazil.
authors.forename: Claudio T
authors.initials: CT
authors.lastname: Mesquita
authors.affiliation: Department of Psychology, University of Florence, Florence, Italy.
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Cosci
authors.affiliation: Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT-Translational Medicine (CNPq), Rio de Janeiro, Brazil.
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Silva
authors.affiliation: Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT-Translational Medicine (CNPq), Rio de Janeiro, Brazil.
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Nardi
mesh_terms: D000328:Adult; D002245:Carbon Dioxide / Q000009:adverse effects*; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D016584:Panic Disorder / Q000139:chemically induced / Q000150:complications*; D015203:Reproducibility of Results
chemical_list: D002245:Carbon Dioxide