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Gray, S.H. (1992). Bulletin of the Menninger Clinic. LIV, 1990: Mitral Valve Prolapse and Panic Disorder. Ashok Raj and David V. Sheehan. Pp. 199-208.. Psychoanal Q., 61:678-679.

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Psychoanalytic Electronic Publishing: Bulletin of the Menninger Clinic. LIV, 1990: Mitral Valve Prolapse and Panic Disorder. Ashok Raj and David V. Sheehan. Pp. 199-208.

(1992). Psychoanalytic Quarterly, 61:678-679

Bulletin of the Menninger Clinic. LIV, 1990: Mitral Valve Prolapse and Panic Disorder. Ashok Raj and David V. Sheehan. Pp. 199-208.

Sheila Hafter Gray

A review of the medical literature reveals that panic has been associated with cardiovascular dysfunction for well over a century. More recently, investigators have


WARNING! This text is printed for the personal use of the PEPWeb subscriber and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form.
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noted that the symptoms of mitral valve prolapse and of panic disorder are nearly identical; but they have not yet clarified the causal relationship of these two disorders.

The differential diagnosis of anxiety includes withdrawal states, intoxication, schizophrenic and depressive disorders, endocrine disorders, complex partial seizures, as well as mitral valve prolapse and other cardiovascular disorders. A diagnosis of mitral valve prolapse dictates screening for panic disorder. Similarly, a diagnosis of panic disorder mandates evaluation and treatment for the complications of mitral valve prolapse.

A multimodal therapeutic approach to panic disorder is most effective. The biological core, which is manifested by eruptions of anxiety in specific feared situations, is controlled with pharmacotherapy. Phobic avoidance is best mitigated with behavior therapy. The psychosocial components of this disorder are resolved through psychotherapy.


WARNING! This text is printed for the personal use of the PEPWeb subscriber and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form.
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Article Citation

Gray, S.H. (1992). Bulletin of the Menninger Clinic. LIV, 1990. Psychoanal. Q., 61:678-679

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WARNING! This text is printed for the personal use of the subscriber to PEP Web and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form whatsoever.