OBJECTIVES: The purpose of this study was to assess the prevalence of cardiac and psychiatric diagnoses in patients with chest pain and palpitations. DESIGN: 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. CONCLUSION: 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.
OBJECTIVES: The purpose of this study was to assess the prevalence of cardiac and psychiatric diagnoses in patients with chest pain and palpitations. DESIGN: 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. CONCLUSION: 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.