tailieunhanh - Báo cáo y học: "Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài:Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports. | Domschke et al. Annals of General Psychiatry 2010 9 13 http content 9 1 13 ANNALS OF GENERAL PSYCHIATRY CASE REPORT Open Access Co incidence of paroxysmal supraventricular tachycardia and panic disorder two case reports Katharina Domschke 1 Paulus Kirchhof2 Peter Zwanzger1 Alexander L Gerlach3 Gunter Breithardt2 and Jurgen Deckert4 Abstract Panic disorder PD is characterised by sudden attacks of intense fear with somatic symptoms including palpitations and tachycardia. Reciprocally palpitations caused by paroxysmal supraventricular tachycardia PSVT are commonly associated with anxiety and may therefore be misdiagnosed as PD. As demonstrated by two case reports PSVT and PD can occur comorbidly in a chronological sequence with PSVT possibly precipitating and maintaining PD via interoceptive processes or alternatively with PD increasing the risk for PSVT by elevating stress levels. As both PSVT and PD require different treatments potentially helpful differential clinical diagnostic criteria are proposed. Background Panic disorder PD is characterised by a lifetime prevalence of 1 to 3 and sudden attacks of intense fear accompanied by somatic particularly cardiac symptoms such as palpitations chest pain and tachycardia 89 of patients with PD complain of palpitations with up to 25 of patients initially referred to cardiac clinics with atypical chest pain or palpitations being later diagnosed with PD 1 . Reciprocally palpitations caused by paroxysmal supraventricular tachycardia PSVT are associated with anxiety in approximately 20 of patients and may therefore be misdiagnosed as PD 2-4 . In patients with PSVT radiofrequency ablation offers a curative therapy and can reduce anxiety symptoms dramatically. After successful catheter ablation a minority of patients has been reported to still suffer from panic symptoms pointing to a possible true comorbidity in at least 4 of cases 5 . Based on two case reports of patients with comorbid PSVT and

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