Panic attack: Difference between revisions
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==Background== | ==Background== | ||
==Clinical Features== | ==Clinical Features== | ||
*Discrete period of intense fear or discomfort that peaks within a few minutes '''plus'' at least four of the following:<ref name="Foldes">Foldes-Busque G, Denis I, Poitras J, Fleet RP, Archambault P, Dionne CE. A prospective cohort study to refine and validate the Panic Screening Score for identifying panic attacks associated with unexplained chest pain in the emergency department. BMJ Open. 2013;3(10):e003877. doi:10.1136/bmjopen-2013-003877.</ref> | |||
**Chest pain | |||
**Palpitations | |||
**Dyspnea | |||
**Feeling of suffocation | |||
**Diaphoresis | |||
**Hot or cold flashes | |||
**Nausea | |||
**Fear of death | |||
**Fear of losing control | |||
**Trembling | |||
**Paresthesias | |||
**Depersonalization | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{SOB DDX}} | {{SOB DDX}} | ||
== | ==Diagnosis== | ||
*Clinical diagnosis, based on history and physical exam. | |||
==Management== | ==Management== | ||
*1-2mg [[ | *Reassurance and patient education | ||
*1-2mg [[Lorazepam]] (Ativan) IV/IM | |||
==Disposition== | ==Disposition== | ||
*Discharge | |||
==See Also== | ==See Also== | ||
*[[Shortness of breath]] | *[[Shortness of breath]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Psych]] | [[Category:Psych]] | ||
Revision as of 05:27, 18 August 2015
Background
Clinical Features
- Discrete period of intense fear or discomfort that peaks within a few minutes 'plus at least four of the following:[1]
- Chest pain
- Palpitations
- Dyspnea
- Feeling of suffocation
- Diaphoresis
- Hot or cold flashes
- Nausea
- Fear of death
- Fear of losing control
- Trembling
- Paresthesias
- Depersonalization
Differential Diagnosis
Acute dyspnea
Emergent
- Pulmonary
- Airway obstruction
- Anaphylaxis
- Angioedema
- Aspiration
- Asthma
- Cor pulmonale
- Inhalation exposure
- Noncardiogenic pulmonary edema
- Pneumonia
- Pneumocystis Pneumonia (PCP)
- Pulmonary embolism
- Pulmonary hypertension
- Tension pneumothorax
- Idiopathic pulmonary fibrosis acute exacerbation
- Cystic fibrosis exacerbation
- Cardiac
- Other Associated with Normal/↑ Respiratory Effort
- Other Associated with ↓ Respiratory Effort
Non-Emergent
- ALS
- Ascites
- Uncorrected ASD
- Congenital heart disease
- COPD exacerbation
- Fever
- Hyperventilation
- Interstitial lung disease
- Neoplasm
- Obesity
- Panic attack
- Pleural effusion
- Polymyositis
- Porphyria
- Pregnancy
- Rib fracture
- Spontaneous pneumothorax
- Thyroid Disease
- URI
Diagnosis
- Clinical diagnosis, based on history and physical exam.
Management
- Reassurance and patient education
- 1-2mg Lorazepam (Ativan) IV/IM
Disposition
- Discharge
See Also
References
- ↑ Foldes-Busque G, Denis I, Poitras J, Fleet RP, Archambault P, Dionne CE. A prospective cohort study to refine and validate the Panic Screening Score for identifying panic attacks associated with unexplained chest pain in the emergency department. BMJ Open. 2013;3(10):e003877. doi:10.1136/bmjopen-2013-003877.