Cardiac and psychiatric diagnoses among patients referred for chest pain and palpitations

Scand Cardiovasc J. 2009 Aug;43(4):256-9. doi: 10.1080/14017430902946749.


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.

MeSH terms

  • Angina Pectoris / etiology
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / etiology*
  • Arrhythmias, Cardiac / psychology
  • Chest Pain / epidemiology
  • Chest Pain / etiology*
  • Chest Pain / psychology
  • Coronary Angiography
  • Depressive Disorder, Major / diagnosis
  • Electrocardiography, Ambulatory
  • Exercise Test
  • Female
  • Heart Diseases / complications
  • Heart Diseases / diagnosis*
  • Heart Diseases / epidemiology
  • Humans
  • Male
  • Mental Disorders / complications
  • Mental Disorders / diagnosis*
  • Mental Disorders / epidemiology
  • Middle Aged
  • Myocardial Perfusion Imaging
  • Panic Disorder / diagnosis
  • Predictive Value of Tests
  • Prevalence
  • Psychiatric Status Rating Scales
  • Somatoform Disorders / diagnosis