About this Journal Submit a Manuscript Table of Contents
Cardiovascular Psychiatry and Neurology
Volume 2009 (2009), Article ID 453786, 3 pages
http://dx.doi.org/10.1155/2009/453786
Case Report

Depression with Panic Episodes and Coronary Vasospasm

1Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 South Wood Street, MC 715, Suite 935, Chicago, IL 60612, USA
2Heart and Mind Clinic, University of Illinois at Chicago, Chicago, IL 60612, USA
3Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA

Received 18 March 2009; Accepted 9 May 2009

Academic Editor: Ilan S. Wittstein

Copyright © 2009 Mladen I. Vidovich et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Variant (Prinzmetal's) angina is an uncommon cause of precordial pain caused by coronary vasospasm and characterized by transient ST elevation and negative markers of myocardial necrosis. This is the case of a female patient with a prior history of depression and panic attacks who presented with recurrent symptoms including chest pain. A cardiac event monitor positively documented coronary vasospasm associated with anxiety-provoking chest pain, whereas the coronary arteries were angiographically normal. We noted that the frequency of angina attacks apparently increased during the period that coincided with the introduction of Bupropion SR for treatment of the patient's depression. Considering the possibility of bupropion-associated negative impact on coronary vasospasm, the antidepressant therapy was adjusted to exclude this drug. Although Prinzmetal's angina is relatively uncommon, we suspect that a routine use of cardiac event monitors in subjects with panic disorder might reveal a greater incidence of coronary vasospasm in this patient population.