Alleviating Effect of Antidepressant Treatment on Psychiatric Symptoms and Cardiac Conditions in a Patient with Coronary Slow Flow Comorbid with Depression and Anxiety

Patient: Female, 52 Final Diagnosis: Coronary slow flow Symptoms: Frequent chest pain • serious TIMI grade 2 flow without any coronary stenosis • comorbid with depression and anxiety Medication: — Clinical Procedure: — Specialty: Psychiatry OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Depressive patients are considerably more likely to suffer cardiovascular disease (CVD), and in patients with CVD, depression is a predictor of poor outcome. Recent findings suggest higher rates of depression and anxiety in patients with coronary slow flow (CSF). However, there is no research investigating whether the antidepressant treatment can mitigate psychiatric symptoms and cardiac conditions in CSF patients comorbid with depression. CASE REPORT: The patient was a 52-year-old Chinese female with frequent chest pain. The patient had serious TIMI (thrombolysis in myocardial infarction) grade 2 flow without any coronary stenosis, but comorbid with depression and anxiety. The CSF was very likely associated with her mental health condition, given that the chest distress and intermittent chest pain followed psychological stress and disturbed sleep. Therefore, paroxetine was used under the circumstances of the poor effect of cardiovascular active drugs. We found that the adjunctive use of paroxetine not only improved the psychiatric symptoms, but also alleviated the cardiac conditions. CONCLUSIONS: Our findings strengthen the importance of the treatment of psychiatric symptoms in patients with CSF and this finding should promote randomized controlled trials in a larger population to confirm the beneficial effects of antidepressant treatment on psychiatric symptoms and cardiac conditions in CSF patients with psycho-cardiac conditions.