Panic Disorder and the Cardiac Function(Bases and Clinical Practice of Anxiety and Depression)

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  • パニック障害患者と心循環器系機能(不安と抑うつの基礎と臨床)(第37回日本心身医学会総会)
  • パニック障害患者と心循環器系機能
  • パニック ショウガイ カンジャ ト シン ジュンカンキケイ キノウ

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Abstract

The cardiac symptoms such as palpitation and chest pain are common in patients with panic disorder (PD). The PD patients with chest pain often underwent coronary arteriography because of fear of possible serious cardiac disease. However, the prevalence of PD is very high among the patients who have chest pain and normal coronary arteriograms. The mitral valve prolapse (MVP) syndrome has symptoms indistinguishable from panic attacks. The studies with two-dimensional echocardiography and blind evaluation of MVP found significantly higher prevalences of mild MVP in PD patients than in the control groups. Our study confirmed this finding as well. We compared the heart rate and the R-R interval varianace (CV= standard deviation of R-R intervals/mean R-R intervals X 100) of 32 PD patients with those of 32 age and sex matched healthy controls. The heart rate in the lying position tended to be higher in PD patients than in the healthy controls. And in the standing position, it was significantly higher in PD patiens than in the controls. In the lying position, CV of R-R was smaller in PD patients than in healthy controls. These findings suggested that PD patients had sympathetic arousal and vagal withdrawal. Then the heart rate and CV of R-R interval of 15 PD patients with MVP were compared with those of 15 PD patiens without MVP. The age and sex of the both groups were matched. The PD patients with MVP had smaller CV than PD patients without MVP. It was suggested that the cardiac vagal withdrawal was more prominent in PD patients with MVP.

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