بررسي شيوع حملات پانيك در بيماران با پرولاپس دريچه ميترال

PANIC ATTACKS IN PATIENTS WITH MITRAL VALVE PROLAPSE

Mitral valve prolapse (MVP) and panic attacks occur with a frequency of 2-5%, mostly in the young and women, and have thus far been the focus of many researchersʹ attention. The wide range of symptoms that accompany MVP, as well as the similarity of etiologic factors that trigger panic attacks and those which underlie symptoms of MVP have incited several studies, some of which have demonstrated a statistically significant relation between frequency of panic attacks and presence of MVP, whereas some have not confirmed such results. The objective of this study was to investigate the relation between MVP and panic attacks in a well-known population. This was a case control cohort historical study of 129 patients with MVP and 43 individuals in the control group. Echocardiographic studies and cardiac examinations in different positions were conducted by using single echocardiographic equipment and one person respectively. To evaluate the frequency of panic attacks in the population under study, a checklist designed in accordance with DSM IV criteria was filled out for every patient. For prevention of interviewer bias, the interviewer wasnʹt informed about the patientsʹ cardiac diagnosis prior to the interview. Patients who developed panic attacks during exertion, or due to opium use were excluded from the study. In this study, 59% of patients with MVP (the case group) and 30% of individuals in the control group suffered from panic attacks (P<0.05). Statistical analyses of data from both groups revealed no significant relation between patientsʹ level of education and panic attacks, sex and panic attacks, or recent accident and panic attacks. Neither did panic attacks tend to affect a certain age group. The frequency of a panicattack and its relative risk in the present study was 59% and 1.96% respectively. A similar study, reviewing 21 articles has calculated the relative risk of panic attack at 2.3. Another study has put the concurrence rate of MVP and panic attack in patients with depression at 58.1%. A different study has calculated the frequency of panic attack in patients with MVP at 16-33%. Given the likely concurrence of MVP and panic attacks, as suggested by different studies, we recommend that physicians take adequate notice of symptoms related to each of these conditions, when planning their overall diagnostic and therapeutic strategies.