Panics, prolapse, and PVCs.

There is a group of patients who presents with intense anxiety and physical complaints suggestive of cardiac or gastrointestinal disease. These patients are more commonly women and complain of palpitations, lightheadedness, chest pains, and dyspnea. A work-up may reveal positive findings such as extrasystoles and mitral valve prolapse that appear to confirm the organic etiology of the symptoms. Evidence is presented that the positive findings serve to confuse the picture and are an impediment, rather than an aid, to the physician in making the correct diagnosis. Effective treatment using tricyclic antidepressants or monoamine oxidase inhibitors is suggested.