Be Cautious Diagnosing Anxiety and Panic Disorder in Patients with Chest Pain and Anxiety

Patients with acute life-threatening cardiac or pulmonary conditions frequently present with feelings of panic or impending doom in association with chest pain. This may even be in the setting of a stressful situation and mislead the EP to feel confident that anxiolytic therapy and reassurance is all that may be needed.

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Consider Aortic Dissection in Patients with Chest Pain and Ischemic ECGs

In Aortic Dissection, a defect in the aortic intima allows entry of blood into the tunica media. A false lumen develops and can propagate in an anterograde or retrograde direction. Aortic Dissections that involve the ascending aorta (Stanford type A) can cause coronary insufficiency by several mechanisms.

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