One-year psychosocial follow-up of patients with chest pain and angiographically normal coronary arteries

Lantinga, Larry J.; Sprafkin, Robert P.; McCroskery, James H.; Baker, Marilyn; Warner, Robert A.; Hill, Norma E.

doi:10.1016/0002-9149(88)90213-5

Cited by 113 publications

(46 citation statements)

References 21 publications

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“…However, only 22% of the PD patients had remitted during the first year after the evaluation. This is in line with Lantinga et al who reported that high levels of neuroticism was not only associated with anticipatory stress before cardiac catheterization, but persisted one year after the procedure was carried out (25).…”

Section: Prevalence Of Panic Disorder At Follow-upsupporting

confidence: 90%

A 1-year follow-up study of chest-pain patients with and without panic disorder

Dammen

Bringager

Arnesen

et al. 2006

General Hospital Psychiatry

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Section: Prevalence Of Panic Disorder At Follow-upsupporting

confidence: 90%

A 1-year follow-up study of chest-pain patients with and without panic disorder

Dammen

Bringager

Arnesen

et al. 2006

General Hospital Psychiatry

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“…In cardiac out-patients, the prevalence of non-cardiac chest pain is 20–50% [1, 2, 3, 4, 5]. There is a high rate of co-morbidity with anxiety/panic disorder and hypochondriasis in patients with non-cardiac chest pain [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Change following Cognitive Behavioural Therapy for Non-Cardiac Chest Pain

Peski-Oosterbaan¹,

Spinhoven

Does³

et al. 1999

Psychother Psychosom

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Background: Seventeen to 43% of patients with non-cardiac chest pain suffer from anxiety/panic disorders. Cognitive behavioural therapy (CBT) is effective in reducing non-cardiac chest pain. However, no data are available indicating that pain reduction following CBT may be cognitively mediated or whether success of CBT is dependent on the presence of panic. The aim of the study was threefold: (1) does CBT have a differential effect on cognitive measures; (2) does a relationship exist between improvement in non-cardiac chest pain and changes in cognitive measures, and (3) can panic be established as a moderator of the effect of treatment? Methods: Sixty-five patients with non-cardiac chest pain completed a randomised trial comparing study CBT with ‘care as usual’. Dependent measures were: frequency of chest pain, anxiety, the fear of bodily sensations, attributions and catastrophic cognitions. Results: CBT had a differential effect on most of the cognitive measures. Pain reduction was associated with the development of more adequate cognitions with respect to chest pain, independent of anxiety reduction. Although panic patients reported higher baseline scores on the cognitive measures, no differences in treatment results were found between panic and no-panic patients. Conclusions: Pain reduction following CBT may be cognitively mediated. The presence of panic did not affect the outcome of treatment, implying a broad applicability of the cognitive model for treatment of patients with non-cardiac chest pain.

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“…Eighty six percent of patients with continued chest pain and no evidence of CAD were found to have chest pain at least weekly for up to one year post-angiogram, with unchanged or even worsening pain, and with half reporting functional disability including limitations on activities of daily living and/or inability to work [9,10]. Despite open coronary angiograms, twenty to fifty percent of patients are re-hospitalized for chest pain with an average lifetime cost per patient set at approximately eight hundred thousand dollars [7].…”

Section: Discussionmentioning

confidence: 99%

Microvascular Coronary Dysfunction in a Woman With Signs and Symptoms of Myocardial Ischemia but No Obstructive Coronary Artery Disease

Kahlon

2013

J Med Cases

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Women with signs and symptoms of myocardial ischemia often have no obstructive coronary artery disease by invasive coronary angiography when compared to men. Microvascular coronary dysfunction (MCD) is thought to be a key contributory mechanism for myocardial ischemia in women with chest pain and no obstructive CAD. We report a case of a 53-year-old post-menopausal female with hyperlipidemia evaluated for persistent chest pain following a non-ST elevation myocardial infarction (NSTEMI) and no obstructive CAD by coronary angiography. Vital signs and physical examination were within normal limits. Prior EKG showed diffuse abnormal T wave inversion and flattening in anterior and inferior leads. Echocardiography demonstrated an ejection fraction of 72% with no regional wall motion abnormalities. Laboratory values revealed a positive heterozygote factor V Leiden mutation. Given the constellation of persistent chest pain, no obstructive CAD, and prior NSTEMI, a diagnosis of MCD was suspected and she underwent coronary reactivity testing (CRT) with intracoronary infusions of adenosine, acetylcholine, and nitroglycerin to test non-endothelial and endothelial dependent, micro-and macrovascular coronary function. CRT results were consistent with a diagnosis of MCD. A statin and angiotensin converting enzyme inhibitor was added to her existing treatment of beta-blocker and nitrates. Additionally, she was started on warfarin therapy due to a positive factor V Leiden in the setting of prior NSTEMI. Her symptoms improved at one-month follow-up and she is currently asymptomatic by selfreport. In women with signs and symptoms of myocardial ischemia and no obstructive CAD, it is important to identify and diagnose MCD, as inadequate diagnosis is associated with an increased risk of adverse cardiovascular events including myocardial infarction, congestive heart failure, and sudden cardiac death. Identification of MCD and clinical awareness are vital for optimal medical therapy and reduced CVD risk. Clinical trials testing efficacy of traditional and novel interventions are needed in MCD populations.

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One-year psychosocial follow-up of patients with chest pain and angiographically normal coronary arteries

Cited by 113 publications

References 21 publications

A 1-year follow-up study of chest-pain patients with and without panic disorder

A 1-year follow-up study of chest-pain patients with and without panic disorder

Cognitive Change following Cognitive Behavioural Therapy for Non-Cardiac Chest Pain

Microvascular Coronary Dysfunction in a Woman With Signs and Symptoms of Myocardial Ischemia but No Obstructive Coronary Artery Disease

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