This paper studies the relationship between atrial fibrillation and panic disorder. Doubts about differential diagnosis are usual in emergency services and general medical settings. Panic disorder prevalence rates have been found high in patients suffering from atrial fibrillation. Besides, different studies have observed that frequently, patients diagnosed with anxiety disordes have higher cardiovascular disease rates comparing general population.

Anxiety disorders are very common in general population, and related economic costs are huge. The overutilization of medical services is also present in this patients, and misdiagnosis leads to unnecessary medical evaluations. Usually, patients suffering form panic disorder exhibit somatic complaints suggesting coronary disease such as chest pain or palpitations. Then, correct practiser uses screening test (arteriography, effort test...) to reject cardiovascular disease.

We suggest an algorithm to optimize the differential diagnosis using clinical interview and asking for some aspects that have been demonstrated as highly specific. It is based in five general factors: age, sex, refered anxiety level, typical /atypical chest pain and complementary test. The aim is the correct diagnosis and treatment for such different illnesses and to decrease the costs due to misdiagnosis.