Mental Stress-Induced Myocardial Ischemia Related to Generalized Anxiety Disorder in a Patient With Acute Coronary Syndrome and Normal Coronary Arteries.
Mental stress-induced myocardial ischemia (MSIMI) has been described in patients with acute coronary syndrome (ACS). We reported the case of a patient admitted with ACS and MSIMI related to generalized anxiety disorder (GAD). Myocardial perfusion imaging (MPI) after exercise stress and computed tomography coronary angiography showed normal results. In contrast, MPI with mental stress documented MSIMI. He began to improve 7 days after starting escitalopram and remained without angina at 1-year follow-up. These data suggest the applicability of mental stress radionuclide imaging for the detection of MSIMI in patients with ACS and GAD, even in normal coronary arteries.
From the *Federal University of the State of Rio de Janeiro, Rio de Janeiro; †State University of Rio de Janeiro, Rio de Janeiro; ‡Fluminense Federal University of Rio de Janeiro, Hospital Universitário Antônio Pedro, Rio de Janeiro; and §Pró-Cardíaco Hospital, Rio de Janeiro, Brazil.
Julio Cesar
JC
Tolentino
Juliana J
JJ
Schmidt
Guilherme J
GJ
Schmidt
Claudio Tinoco
CT
Mesquita
Sergio L
SL
Schmidt
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology / Q000523:psychology; D001008:Anxiety Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D015283:Citalopram / Q000627:therapeutic use; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005080:Exercise Test; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000523:psychology; D055414:Myocardial Perfusion Imaging; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013315:Stress, Psychological / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D055815:Young Adult
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors