Jonsbu Egil, Dammen Toril, Morken Gunnar, Lied Arne, Vik-Mo Harald, Martinsen Egil W
Department of Psychiatry, Molde Hospital, Molde, Norway.
Scand Cardiovasc J. 2009 Aug;43(4):256-9. doi: 10.1080/14017430902946749.
The purpose of this study was to assess the prevalence of cardiac and psychiatric diagnoses in patients with chest pain and palpitations.
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.
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.
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.
本研究旨在评估胸痛和心悸患者中心脏疾病及精神疾病诊断的患病率。
连续纳入198例年龄在18至65岁之间、因胸痛或心悸到心脏门诊接受评估的患者。排除有心脏病史且经心脏病专家确诊的患者。最终样本包括160例患者。心脏评估包括自行车运动负荷试验、心肌闪烁显像、冠状动脉造影或动态心电图监测。精神评估包括诊断性访谈。
冠心病患病率为4%。未检测到需要治疗的心律失常病例。在无冠心病的患者中，精神障碍患病率为39%：惊恐障碍14%，躯体形式障碍14%，重度抑郁症5%。
心脏疾病罕见，惊恐障碍和躯体形式障碍的患病率约为心脏疾病的三倍。该研究表明，对于因胸痛或心悸就诊的患者，制定识别精神障碍的策略非常重要。
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