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. 2014 Oct 7;1(1):e000093.
doi: 10.1136/openhrt-2014-000093. eCollection 2014.

Mental symptoms in patients with cardiac symptoms and normal coronary arteries

Marian Christoph  1 , Antje Christoph  2 , Stephanie Dannemann  3 , David Poitz  1 , Christian Pfluecke  1 , Ruth H Strasser  1 , Carsten Wunderlich  1 , Volker Koellner  4 , Karim Ibrahim  1
Affiliations

Mental symptoms in patients with cardiac symptoms and normal coronary arteries

Marian Christoph et al. Open Heart. .

Abstract

Objectives: Patients with chest pain and normal coronary arteries often suffer from physical and psychological symptoms. Therefore, this study aimed to examine the incidence of mental symptoms in patients with angiographic exclusion of a coronary heart disease.

Design: In 253 patients with angiographic exclusion of a coronary heart disease the type and intensity of their symptoms were evaluated before and after coronary angiography. In addition, the incidence of psychopathological symptoms was quantified by standardised questionnaires such as general anxiety and depression (HADS), heart-focused anxiety (CAQ), hypochondria (Whiteley Index) and somatoform disorder (SOMS) and quality of life (SF-12). Finally, the incidence of psychological symptoms in these patients was compared to the incidence in the normal population.

Results: Despite the absence of a coronary artery disease, 70% of patients continue to suffer from cardiac symptoms. The incidence of general anxiety was increased by 37% in women and by 22% in men in comparison to the normal population. Heart-focused anxiety was raised by 27%. Somatoform disorder appeared 120% more often in patients after cardiac catheterisation in comparison to the normal population. In addition, the incidence of hypochondria was elevated by 68% in patients after coronary angiography compared to normal population. This increased appearance of psychological symptoms was reflected in a significantly lower quality of life (SF-12) in patients with inconspicuous coronary angiography.

Conclusions: Patients with cardiac symptoms and normal coronary arteries more often suffer from mental symptoms in comparison to the healthy population.

Keywords: CORONARY ARTERY DISEASE.

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Figures

Figure 1
Figure 1
Flow chart of study design and in/excluded patients.
Figure 2
Figure 2
Relative frequency of complaint intensity (%).
Figure 3
Figure 3
Comparison between non-cardiac chest pain patients and healthy population. CAQ, Cardiac Anxiety Questionnaire with the three subscales; Fear (CAQ-F), Avoidance (CAQ-Av) and Attention (CAQ At); HADS, Hospital Anxiety and Depression Scale with the two subscales; SOMS, Screening for Somatoform Disorders; WI, Whiteley Index.
Figure 4
Figure 4
Comparison of quality of life (QoL) between non-cardiac chest pain patients and healthy population. Physical QoL: Physical quality of life subscale of the SF-12; Psychol QoL: Psychological quality of life subscale of the SF-12; t-test: *p<0.01; #p=0.013; +p<0.001; $p<0.001.
See this image and copyright information in PMC

References

    1. Rosch PJ. Risk of coronary artery disease. JAMA 1983;249:2178–9. - PubMed
    1. Joukamaa M, Heliovaara M, Knekt P, et al. Mental disorders and cause-specific mortality. Br J Psychiatry 2001;179:498–502. - PubMed
    1. Mykletun A, Bjerkeset O, Overland S, et al. Levels of anxiety and depression as predictors of mortality: the HUNT study. Br J Psychiatry 2009;195:118–25. - PubMed
    1. White KS, Craft JM, Gervino EV. Anxiety and hypervigilance to cardiopulmonary sensations in non-cardiac chest pain patients with and without psychiatric disorders. Behav Res Ther 2010;48:394–401. - PMC - PubMed
    1. Hotopf M, Mayou R, Wadsworth M, et al. Psychosocial and developmental antecedents of chest pain in young adults. Psychosom Med 1999;61:861–7. - PubMed

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