Korean Circ J.  2016 Mar;46(2):169-178. 10.4070/kcj.2016.46.2.169.

Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain

• Lee JG
• Choi JH
• Kim SY
• Kim KS
• Joo SJ

• KMID: 2344468
• DOI: http://doi.org/10.4070/kcj.2016.46.2.169

Abstract

BACKGROUND AND OBJECTIVES
A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain.
SUBJECTS AND METHODS
Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were excluded and 108 were enrolled for the present study. The enrolled patients underwent complete numerical rating scale of chest pain and the symptom checklist for minor psychiatric disorders at the time of first outpatient visit. The non-CAD group consisted of patients with a normal stress test, coronary computed tomography angiogram, or coronary angiogram, and the CAD group included those with an abnormal coronary angiogram.
RESULTS
Nineteen patients (17.6%) were diagnosed with CAD. No differences in the psychiatric characteristics were observed between the groups. "Feeling tense", "self-reproach", and "trouble falling asleep" were more frequently observed in the non-CAD (p=0.007; p=0.046; p=0.044) group. In a multiple linear regression analysis with a stepwise selection, somatization without chest pain in the non-CAD group and hypochondriasis in the CAD group were linearly associated with the intensity of chest pain (β=0.108, R2=0.092, p=0.004; β= -0.525, R2=0.290, p=0.010).
CONCLUSION
No differences in psychiatric characteristics were observed between the groups. The intensity of chest pain was linearly associated with somatization without chest pain in the non-CAD group and inversely linearly associated with hypochondriasis in the CAD group.

Keyword

Chest pain; Coronary disease; Psychology

MeSH Terms

Cardiology
Checklist
Chest Pain*
Coronary Artery Disease
Coronary Disease
Dyspnea
Exercise Test
Humans
Hypochondriasis
Linear Models
Outpatients*
Psychology
Thorax*

Figure

• 

  Fig. 1 The flow diagram used to differentiate between the CAD and non-CAD groups from the point of admission to the cardiology outpatient department. CAD: coronary artery disease, CAG: coronary angiography, CCTA: coronary artery computed tomography angiography, SPECT: single-photon emission computed tomography, TMT: treadmill test.

• 

  Fig. 2 The relationships between the intensity of chest pain and psychological symptom dimensions. Somatization without chest pain in the non CAD group (A). Hypochondriasis in the CAD group (B). CAD, coronary artery disease.

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