Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Panic Attacks in Patients with Supraventricular Tachycardia: Problems of Differential Diagnosis and Impact on Quality of Life

https://doi.org/10.20996/1819-6446-2021-12-09

Full Text:

Abstract

Aim. To study the psychosomatic relationships and quality of life (QOL) of patients with paroxysmal supraventricular tachycardia (SVT) depending on the presence or absence of panic attacks (PA) in comparison with patients with heartbeat against the background of somatoform autonomic dysfunction.

Material and methods. The study included patients with SVT and heart attacks due to sinus tachycardia in the context of somatoform autonomic disorder (SAD). All patients were interviewed to identify anxiety and depressive disorders (Hospital Anxiety and Depression Scale [HADS] and Hamilton's Depression Scale), QOL assessment (SF-36 questionnaire), and they were also consulted by a psychiatrist who established the presence or absence of PA. According to a visual analogue scale, in points from 0 to 6, we assessed the general state of our patients' health (0 points corresponded to complete health, and 6 points corresponded to a serious illness) and the effect of heartbeat on well-being (0 points - no arrhythmia, 6 points - arrhythmia «nterferes with life»).

Results. The study included 96 patients: 60 with SVT (21 men, 39 women, average age was 51 [33; 61] years) and 36 with heart attacks caused by sinus tachycardia in the framework of somatoform autonomic disorder (10 men, 26 women, average age was 33 [27; 41] years). Panic disorder was diagnosed in the SVT group in 17 patients, accounting for 28.3%. Only 7 patients (41%) could clearly differentiate between SVT and PA attacks. The low sensitivity of the HADS questionnaire in patients with SVT determined the need to consult a psychiatrist for the diagnosis of panic disorders.

Conclusion. PA is typical for 28.3% of patients with SVT. The combination of SVT with PA reduces the QOL of patients due to its mental components, including due to the more frequent occurrence of depressive symptoms. Patients with SAD subjectively perceive the heartbeat as a more significant factor affecting health, compared with patients with SVT. Difficulties in the differential diagnosis of PA and SVT paroxysms in real clinical practice often lead to the appointment of the same therapy without taking into account the differences in the genesis of heartbeats.

About the Authors

D. A. Tsaregorodtsev
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Dmitrii A. Tsaregorodtsev.

Moscow.

eLibrary SPIN 2840-5301



P. A. Shelukha
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Polina A. Shelukha.

Moscow.

eLibrary  SPIN 3424-7156



L. V. Romasenko
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Lubov V. Romasenko.

Moscow.

eLibrary SPIN 6225-4232



M. M. Beraya
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Maka M. Beraya.

Moscow.

eLibrary SPIN 4124-3813



A. V. Sokolov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Aleksey V. Sokolov.

Moscow.

eLibrary  SPIN  8265-4292



References

1. Kitzlerová E, Anders M, Kautzner J, Dohnalová A. Evaluation of psychopathology in patients with paroxysmal supraventricular tachycardia. Exp Clin Cardiol. 2007;12(1):42-5.

2. Raviele A, Giada F, Bergfeldt L, et al. European Heart Rhythm Association. Management of patients with palpitations: a position paper from the European Heart Rhythm Association. Europace 2011;13(7):920-34. DOI: 10.1093/europace/eur130.

3. Alijaniha F, Noorbala A, Afsharypuor S, et al. Relationship Between Palpitation and Mental Health. Iran Red Crescent Med J. 2016;18(3):e22615. DOI:10.5812/ircmj.22615.

4. Probst MA, Mower WR, Kanzaria HK, et al. Analysis of emergency department visits for palpitations (from the National Hospital Ambulatory Medical Care Survey). Am J Cardiol. 2014;113(10):1685-90. DOI:10.1016/j.amjcard.2014.02.020.

5. Weber BE, Kapoor WN. Evaluation and outcomes of patients with palpitations. Am J Med. 1996;100(2):138-48. DOI:10.1016/s0002-9343(97)89451-x.

6. Barsky AJ, Delamater BA, Clancy SA, et al. Somatized psychiatric disorder presenting as palpitations. Arch Intern Med. 1996;156(10):1102-8.

7. Lessmeier TJ, Gamperling D, Johnson-Liddon V, et al. Unrecognized paroxysmal supraventricular tachycardia. Potential for misdiagnosis as panic disorder. Arch Intern Med. 1997;157(5):537-43.

8. Pogosov AV, Nikolaevskaja AO. Clinical and dynamic features of somatized mental disorders with cardiovascular manifestations in patients of the city polyclinic. Siberian Bulletin of Psychiatry and Narcology. 2017;2(95):67-72 (In Russ.).

9. Frommeyer G, Eckardt L, Breithardt G. Panic attacks and supraventricular tachycardias: the chicken or the egg? Neth Heart J. 2013;21(2):74-7. DOI:10.1007/s12471-012-0350-2.

10. Domschke K, KirchhofP, Zwanzger P, et al. Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports. Ann Gen Psychiatry. 2010;9:13. DOI:10.1186/1744-859X-9-13.

11. de Jonge P, Roest AM, Lim CC, et al. Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depress Anxiety. 2016;33(12):1155-77. DOI:10.1002/da.22572.

12. Amirdzhanova VN, Goryachev LV, Korshunov NI, et al. Population indicators of the quality of life according to the SF-36 questionnaire (results of the multicenter study of the quality of life "MIRAGE"). Scientific and Practical Rheumatology. 2008;(1):36-48 (In Russ.)

13. Brugada J, Katritsis DG, Arbelo E, et al. ESC Scientific Document Group. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(5):655-720. DOI:10.1093/eurheartj/ehz467.

14. Ballenger JC. Comorbidity of panic and depression: implications for clinical management. Int Clin Psychopharmacol. 1998;13(l4):13-7. DOI:10.1097/00004850-199804004-00003.

15. Morris A, Baker B, Devins GM, Shapiro CM. Prevalence of panic disorder in cardiac outpatients. Can J Psychiatry. 1997;42(2):185-90. DOI:10.1177/070674379704200209.

16. Kanaeva LS, Tsaregorodtsev DA, Romasenko LV, Mahaeva DV. Systematization of mental disorders in cardiac arrhythmias. Mental Health. 2020;11:62-72 (In Russ.).

17. Walfridsson U, Walfridsson H, Arestedt K, Strömberg A. Impact of radiofrequency ablation on health-related quality of life in patients with paroxysmal supraventricular tachycardia compared with a norm population one year after treatment. Heart Lung. 2011;40(5):405-11. DOI:10.1016/j.hrtl-ng.2010.09.004.

18. Makolkin VI, Abbakumov SA, Sapozhnikov AA. Neurocirculatory dystonia (clinic, diagnosis, treatment). Cheboksary: Chuvashia; 1995 (In Russ.).


Review

For citation:


Tsaregorodtsev D.A., Shelukha P.A., Romasenko L.V., Beraya M.M., Sokolov A.V. Panic Attacks in Patients with Supraventricular Tachycardia: Problems of Differential Diagnosis and Impact on Quality of Life. Rational Pharmacotherapy in Cardiology. 2021;17(6):860-866. https://doi.org/10.20996/1819-6446-2021-12-09

Views: 63


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)