Objective: To determine how many patients, presenting to a First Heart Aid (FHA) with chest pain or palpitations without a cardiac origin for their complaints, have a panic disorder and/or depression.
Design: Prospective and questionnaire investigation.
Method: In 3 months (November 1st 1998-January 31st 1999) all patients presenting to the FHA of the University Hospital Maastricht, the Netherlands, and who were not admitted, were screened for the presence of psychopathology by means of a questionnaire, the 'Hospital anxiety and depression scale' (HADS). Patients scoring above 8 on the HADS with no cardiac cause for their initial complaint were interviewed using the 'Mini international neuropsychiatric interview' (MINI) to determine whether there was a panic disorder and/or a depressive episode.
Results: Of a total of 621 patients 251 met the inclusion criteria; 134 (53%) gave informed consent (72 (54%) men and 62 (46%) women, with a mean age of 55.9 (SD: 13.2; range: 23-84)). Of the 134, 77 had a HADS score > or = 8; in 59 (30 men; 29 women) the MINI was carried out; in 49 (83%) panic disorder (n = 45) or depression (n = 4) was diagnosed. In 7/45 the cardiologist had diagnosed a psychiatric disorder ('Hyperventilation').
Conclusion: In 83% of the patients who visited the Maastricht FHA with cardiac complaints but without a cardiac origin and who had a HADS score > or = 8, panic disorder and/or depression was diagnosed.