[Are panic attacks really harmless? The cardiovascular impact of panic disorder].

OBJECTIVE Psychosocial stress and depression have already been established as risk factors for developing and worsening cardiovascular diseases. Anxiety disorders are been strongly associated to cardiac problems nowadays. Panic disorder in cardiac patients represents a challenge for diagnose and treatment. Update the reader on the status of the association between anxiety disorders, particularly panic disorder, in cardiac patients. METHOD Were retrieved papers published at ISI and Medline databases since 1998. Key-words used were: 'heart disease', 'coronary disease', 'anxiety', 'panic disorder' and 'autonomic function'. DISCUSSION The characteristic autonomic pattern found in patients with panic disorder, particularly the reduction in heart rate variability, are discussed as potential mediators of the cardiovascular impact of panic disorder. CONCLUSIONS Despite de established association between panic disorder and cardiac diseases, current literatures data points to a knowledge gap on treating and diagnosing the comorbidity between panic disorder and cardiovascular diseases. Cognitive-behavioral therapy and regular supervised exercise are recommended as potential adjunct therapeutic interventions.