Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Panic attack symptomatology was investigated in 212 panic disorder patients (60 men, 152 women) using the Panic Attack Questionnaire, Feelings of helplessness and thoughts of escape had the highest mean severity ratings, but are not currently listed in the DSM-III-R. The DSM-III-R symptoms labeled choking or smothering sensations, paresthesias, nausea, and chest pain had low severity ratings. Evidence was obtained for a three-factor model of panic symptomatology consisting of dizziness-related symptoms, cardiorespiratory distress, and cognitive factors. These results provide only limited support for the current DSM-III-R symptom structure, and support the notion that panic disorder is a heterogeneous condition.
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PMID:The symptom structure of panic attacks. 799 26

In recent years research has shown that subsets of patients with mitral valve prolapse also have associated autonomic or neuroendocrine dysfunction that can result in a number of related symptoms, including fatigue, palpitations, chest pain, exercise intolerance, dyspnea, dizziness, headache, sleep disorders, gastrointestinal disturbances, cold extremities, and panic attacks. These patients have been classified as having mitral valve prolapse syndrome. This article discusses the pathogenesis and management of mitral valve prolapse syndrome and serves to make clinicians aware of newer developments in the study of autonomic function and dysfunction.
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PMID:The phenomenon of dysautonomia and mitral valve prolapse. 800 50

Although the systolic click was first mentioned in the medical literature in 1887, it was not until the investigations of John Barlow and his colleagues in the 1960s that it became linked to the mitral valve and mitral valve prolapse identified as the cause. Mitral valve prolapse is currently the most commonly diagnosed cardiac valvular abnormality. Significant complications may occur with mitral valve prolapse, though most patients are asymptomatic. However, a number of issues persist regarding mitral valve prolapse, especially with respect to the mitral valve prolapse syndrome, a term which has been applied to patients who develop a variety of symptoms, including chest pain, shortness of breath, fatigue, lightheadedness, syncope, palpitations, anxiety, and panic attacks.
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PMID:John Barlow: mitral valve prolapse. 804 May 99

A panic attack is characterized by the abrupt onset of apprehension or fear, accompanied by symptoms such as dyspnea, palpitations, chest pain, dizziness, sweating, the feeling of going mad or the fear of dying. The feeling of anxiety often recedes into the background and such patients present to nonpsychiatric physicians with mainly somatic symptoms. The consequences of frequent panic attacks, named panic disorder, are agoraphobia with impairment of psychic and social functioning, increased prevalence of alcohol abuse, depression and, in particular, suicidal attempts. It is of the utmost importance that physicians recognize the somatic symptoms of panic anxiety and plan integrated treatment. The main therapeutic resources at present include antidepressants, selected benzodiazepines and behavioral treatments and are very successful in improving panic attacks and their consequences, which may long go undiagnosed.
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PMID:[Panic attacks]. 809 64

Panic disorder is a psychiatric disease without obvious cause. It is accompanied by signs of terror, such as chest pain, palpitation, and shortness of breath. One of every 75 Americans is afflicted. Onset occurs most commonly during adolescence. Some infants and children exhibit anxiety-like responses, such as retreat and avoidance, and behavioral restraint when faced with unfamiliar people, objects, and events. Panel disorder has a special relevance for dentistry, because it is frequently associated with mitral valve prolapse. Furthermore, medications used to treat the disorder are associated with detrimental changes in the oral cavity and adverse interactions with dental therapeutic agents. The authors discuss the podromal characteristics of children at risk for panic disorder and the characteristics of the malady recognized by the American Psychiatric Association. Associated medical problems are also presented and discussed. A survey of ninth graders found as many as 12 percent had spontaneous panic attacks. Approximately 20 percent of all adults with the disorder report its onset before age ten. Etiology, medical and dental management are discussed.
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PMID:Dental management of the adolescent with panic disorder. 812 99

Although panic disorder (PD) and generalized anxiety disorder (GAD) have similar somatic symptoms, panic attacks with chest pain and/or palpitations may seem more likely to be mistaken for heart attacks because of their acute onset. One would therefore expect that PD patients are more likely than GAD patients to seek cardiological consultations. In a survey of 146 PD and 154 GAD patients entering a multi-site drug trial, we found virtually identical rates of such consults. Approximately 50% of each patient group sought medical evaluation for cardiac symptoms. Furthermore, 40% of each group had standard treadmill evaluations and 33% reported having an echocardiogram. This study suggests that future epidemiological studies in cardiology populations should include probes for generalized anxiety disorder.
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PMID:Generalized anxiety disorder patients seek evaluation for cardiological symptoms at the same frequency as patients with panic disorder. 851 89

A randomized, placebo-controlled, double-blind, three-way crossover design was used to evaluate the effectiveness of single oral 100 mg doses of CI-988, a cholecystokinin B (CCKB) antagonist, in attenuating panic symptoms induced by intravenous injection of cholecystokinin-tetrapeptide (CCK-4). Thirty healthy men received the following treatments on three separate occasions: placebo capsules/placebo, placebo capsules/CCK-4, or CI-988 capsules/CCK-4. There was no marked difference in the number, time to onset, or duration of panic symptoms between CI-988/CCK-4 and placebo/CCK-4. There was, however, a 14% difference in sum intensity scores between these treatments that was statistically significant (p = 0.039). The symptoms most affected by CI-988 were cold chills/hot flushes, chest pain/discomfort, and anxiety/fear/apprehension. Panic attack frequency also decreased following CI-988 treatment (8/30 vs. 16/30; p = 0.035). This decrease, amid otherwise modest effects, could be explained by a preferential effect of CI-988 on the subjective experience of anxiety/fear/apprehension. Possible reasons for the relatively modest effects of CI-988 on CCK-4-induced panic symptoms are discussed.
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PMID:Effect of CI-988 on cholecystokinin tetrapeptide-induced panic symptoms in healthy volunteers. 858 Feb 27

Using cluster analysis of 207 patients with panic disorder (PD), we investigated the relationships between several panic symptoms at the time of panic attacks, which included anticipatory anxiety, agoraphobia, and 13 clinical symptoms based on the Diagnostic and Statistics Manual-III-Revised. Cluster analysis revealed three panic symptom clusters: cluster A (dyspnea, choking, sweating, nausea, flushes/chills); cluster B (dizziness, palpitations, trembling or shaking, depersonalization, agoraphobia, and anticipatory anxiety); and cluster C (fear of dying, fear of going crazy, paresthesias, and chest pain or discomfort). Generally, cluster A was comprised exclusively of physiological symptoms, among which respiratory symptoms were prominent, cluster B included both panic and non-panic symptoms such as agoraphobia and anticipatory anxiety, and cluster C was comprised chiefly of fear symptoms.
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PMID:The symptom structure of panic disorder: a trial using factor and cluster analysis. 868 87

This study investigated the frequency and severity of symptoms during naturally occurring panic attacks recollected as "usual" and during sodium lactate-induced attacks. Seventy-six male and 126 female patients with panic disorder or agoraphobics with panic attack (DSM-III criteria) underwent lactate infusion studies and were serially administered the Acute Panic Inventory (API). Fifty-nine percent of the subjects were rated by an attending psychiatrist to have experienced lactate-induced panic attacks. Patients were also asked to API symptom rate their "usual" panic attacks. For panic recollected as usual, the most frequently reported symptoms (> or = 75%) at the moderate to severe levels included: afraid in general, difficulty concentrating, difficulty performing a job, desire to flee, afraid of losing control, palpitations, feeling hot or cold or both, dyspnea, dizzy-lightheaded. During lactate infusion, 25 of 29 API symptoms increased significantly from prelactate to point of panic; however, particularly robust effect sizes were exhibited for the desire to flee, dyspnea, tingling, twitching/trembling and difficulty doing a job. Comparison of panic recollected as usual and lactate-induced panic showed that more than half of the symptoms did not differ after Bonferroni correction; however, the most notable were fear in general, dyspnea, chest pain/discomfort, difficulty swallowing, feeling weak, desire to flee, and feeling hot/cold or both. These data point to a very distinctive role during both recollected and lactate-induced panic attacks for fearfulness the desire to flee (by definition), and for dyspnea, difficulty performing a job and fear of losing control. During lactate-induced panic, dyspnea exhibited the most robust effect size of all physical symptoms.
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PMID:Consistencies between recalled panic and lactate-induced panic. 916 May 44

Panic disorder is a chronic and debilitating illness. In this article, we present an algorithm of the diagnosis and treatment of the illness. We place much importance upon the patient variables associated with the treatment decisions. We emphasize strong patient involvement in treatment as a way to become panic free and improve level of functioning. Panic disorder is defined in DSM-IV1 as "The presence of recurrent panic attacks followed by at least one month of persistent concern about having another panic attack, worry about the possible implications or consequences of the panic attack, or a significant behavioral change related to the attacks." A panic attack is defined as "a discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes." 1) Palpitations, pounding heart or accelerated heart rate; 2) sweating; 3) trembling or shaking; 4) sensations of shortness of breath or smothering; 5) feeling of choking; 6) chest pain or discomfort; 7) nausea or abdominal distress; 8) feeling dizzy, unsteady, light-headed or faint; 9) derealization or depersonalization; 10) fear of losing control or going crazy; 11) fear of dying; 12) paresthesias; 13) chills or hot flashes. The following hypotheses have been used to conceptualize panic disorder from a psychiatrist's perspective.
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PMID:Panic disorder: a different perspective. 949 26


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