A 25 year old female presents to casualty with chest pain, sweating, restlessness, dyspnoea, and palpitation. Enzyme analysis and X-ray are normal. She becomes asymptomatic with suppoive measures. Which of the following is the most probable diagnosis?
Presence of symptoms in the question which respond to suppoive measures along with a normal investigation results suggest a diagnosis of Panic attack. Diagnosis of panic attack requires presence of a period of intense fear or discomfo, associated with the abrupt development of 4 or more of the following symptoms which reaches a peak within 10 minutes: Nausea Sweating Trembling Chest pain Hot flushes Palpitations Fear of dying Parasthesias Feeling of choking Light headedness Shoness of breath Fear of loss of control De realization or depersonalization Panic attacks can occur in mental disorders other than panic disorder, paicularly in specific phobia, social phobia and post traumatic stress disorder. Ref: Medicine at A Glance By Patrick Davey, 3rd Edition, Pages 125-6; Kaplan and Sadock's Concise Textbook of Clinical Psychiatry By Benjamin J. Sadock, 3rd Edition, Page 242
Panic attack
ANS instability
Angina Pectoris
Vasovagal attack