Psychological Comparison of Patients With Cardiac Neurotic Chest Pain and Angina Pectoris

Caston, Joseph; Cooper, Lynne P.; Paley, H. W.

doi:10.1016/s0033-3182(70)71575-2

Cited by 9 publications

(1 citation statement)

References 30 publications

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“…Mayou (1973) reported that, in patients attending a cardiology clinic with chest pain, those with no evidence of organic cardiac disease were characteristically younger, described more atypical chest pains and somatic anxiety symptoms, failed to benefit from trinitrin and had a more frequent history of similar chest pains than patients with demonstrable cardiac lesions. Caston et al (1970) found a predominance of females and a greater incidence of the symptoms and signs attributable to hyperventilation among patients with no demonstrable disease. Waxier et al (1971) estimated that 40% of 86 women investigated and found to have normal coronary arteriograms displayed 'neurotic or hypochondriacal behaviour', but these forms of behaviour were not measured in a standardized way.…”

Section: Introductionmentioning

confidence: 89%

Chest pain with normal coronary arteries: a comparative study of psychiatric and social morbidity

1984

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SynopsisNinety-nine patients with chest pain and a presumptive diagnosis of coronary heart disease were assessed blindly within 24 hours of angiography, using standardized psychiatric and social interviews and a personality inventory. Thirty-one patients had normal coronary arteries (NCA), 15 had slight disease and 53 had significant coronary obstruction. Twenty-eight (61%) of the 46 patients with insignificant disease and 12 (23%) of the 53 with significant obstruction had psychiatric morbidity.Associations between the overall severity of psychiatric morbidity and measures of social maladjustment were strongest in the patients with normal coronary arteries. The 26 men with insignificant coronary artery disease had higher scores of neuroticism and extraversion than the 41 with important coronary occlusions. No differences were observed when the same comparisons were made for the women.The findings indicate that approximately two thirds of patients with normal and near-normal coronary arteries have predominantly psychiatric rather than cardiac disorders: the symptoms in these patients are more likely to represent the somatic manifestations of anxiety and overbreathing than the consequences of underlying cardiac disease. Physicians should be aware of the ways in which neurotic illness may present with symptoms mimicking cardiac disease, especially when cardiovascular symptoms are accompanied by phobic symptoms and unexplained shortness of breath.

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Section: Introductionmentioning

confidence: 89%