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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 1999 March;40(1):35-40

language: Italian

Syncope, hyperventilation and panic disorder

Angelini G., Cascio B.


Studies have reported a high prevalence of psychiatric illness, especially panic disorders, in patients with syncope, particularly among those with syncope of unknown etiology. There is a relationship between panic disorder and the causes of syncope. The medical literature shows that also hyperventilation can cause a syncopal event, because it produces a drop of CO2 pressure, alkalosis, vasoconstriction and a decrease in the cerebral blood flow.
Moreover there is, a strong association between hyperventilation syndrome and panic disorder: their symptoms and physiology are similar, hyperventilation is very common during spontaneous and laboratory-induced panic episodes, anxiety and some psychological factors can cause hyperventilation. Hyperventilation is an important symptom-producing mechanism in panic attacks; panic disorders can be treated with breathing retraining. In this paper, the evidence for an association between these two conditions, and the possible causal relationships between them, are studied.
In the literature three different hypothesis are found: hyperventilation precedes and causes panic, panic causes hyperventilation, both the disorders have a common etiology and they are the expression of the same process; there are many evidences supporting each one of these hypothesis. Since hyperventilation is connected with the pathogenesis both of the syncopes and of the panic attacks, it could be the mechanism joining these two phenomena.

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