Psychiatric Morbidity in Patients Undergoing Cardiac Catheterization

Abstract

One of the more difficult tasks of the emergency physician is to diagnose and manage recurrent chest pain. Most of these patients consult cardiologists. They may undergo expensive and invasive investigations as cardiac catheterization which reveal normal coronary angiograms.

Patients presenting with physical symptoms that remain medically unexplained are common and frustrating occurrence in primary care settings. We have to admit that in our culture people tend to perceive and report emotional distress in somatic terms. In Arab culture physical symptoms are socially accepted than are psychological ones, as psychological ones can be taken to indicate personal weakness or lack of faith. So somatization is one form of illness presentations that implies several cultural connotations. Somatizers are usually unable to talk about personal problems and are less likely to seek help for anxiety or sadness.

Panic disorder is one of the most common anxiety disorder that presented with chest pain, it is considered to be a major health problem which causes remarkable costs for the health services as those patients are seen by non psychiatric physicians. 90% of panic disorder patients have frightening •