Panic disorder in a child with recurrent chest pain.

A 10-year-old boy was admitted to the Pediatric Cardiology Unit with complaints of chest pain and dizziness. Physical examination did not show any pathologic signs. Family history revealed no heart disease and diagnosis of panic disorder (PD) in one of his family members. On follow-up, he was admitted to the pediatric emergency department several times with the same complaint. Organic etiologies of chest pain were excluded by extensive diagnostic work-up. He was referred to the Child and Adolescent Psychiatry Department for further work-up, and PD was diagnosed. A few weeks after starting paroxetine therapy, the frequency and the intensity of the chest pain attacks began to diminish. Early diagnosis of PD will avoid unnecessary investigations and prevent utilization of expensive health services, especially those performed in the emergency department. Physicians should consider that chest pain may be related to psychiatric disorders and refer their patient to mental health professionals for further management. Pharmacological therapy and cognitive-behavioral interventions are successfully used in the management of PD in children and adolescents.