Potokar J P, Nutt D J
Psychopharmacology Unit, School of Medical Sciences, University of Bristol, UK.
Int J Clin Pract. 2000 Mar;54(2):110-4.
Chest pain is a common presentation to both primary and secondary care physicians but is often non-cardiac in origin. Patients presenting with chest pain may be experiencing a panic attack. Panic disorder is a disabling psychiatric condition with serious consequences, such as impaired social functioning and increased risk of suicide. Comorbidity of panic disorder with other psychiatric conditions is common and often leads to increased severity of anxiety symptoms and a poorer prognosis. The cost of misdiagnosing non-cardiac chest pain is high. It is important for physicians to be able to recognise panic attacks and to distinguish them from cardiac disease, thus avoiding unnecessary use of healthcare resources. This review discusses the prevalence and diagnosis of panic attack and panic disorder in patients presenting with chest pain to primary care physicians and cardiologists. Treatment options for panic disorder are considered, particularly the selective serotonin reuptake inhibitors, which are emerging as the first-line choice for the treatment of panic disorder.
胸痛是基层医疗和二级医疗医生常见的诊疗情况，但通常并非源自心脏问题。出现胸痛的患者可能正在经历惊恐发作。惊恐障碍是一种致残性精神疾病，会产生严重后果，如社交功能受损和自杀风险增加。惊恐障碍与其他精神疾病共病很常见，且常常导致焦虑症状加重和预后较差。误诊非心脏性胸痛的代价高昂。医生能够识别惊恐发作并将其与心脏病区分开来很重要，这样可以避免不必要地使用医疗资源。本综述讨论了向基层医疗医生和心脏病专家就诊的胸痛患者中惊恐发作和惊恐障碍的患病率及诊断。文中还考虑了惊恐障碍的治疗选择，尤其是选择性5-羟色胺再摄取抑制剂，这类药物正逐渐成为治疗惊恐障碍的一线选择。
