UP TO ONE THIRD of persons referred for coronary angiography have normal angiograms. Many of those persons may actually be suffering from panic disorder, according to a Seattle investigator.
"With better training of primary care physicians, we may be able to screen out these persons" and avoid costly and potentially dangerous angiograms, says Wayne Katon, MD. Proper diagnosis would also facilitate more effective treatment, he says.
Other Explanations Possible
Others caution that there can be explanations for chest pain besides psychiatric problems. "As a group, patients with chest pain and normal angiograms are a heterogeneous population, and there is no one explanation," says Richard O. Cannon, MD, co-director of the Cardiovascular Diagnosis Section of the National Heart, Lung, and Blood Institute in Bethesda, Md. Cannon has been assessing a group of such patients with normal angiograms and is finding evidence for a still controversial disorder he calls "microvascular angina."Katon,