Panic attack

Revision as of 22:25, 25 September 2016 by Rossdonaldson1 (talk | contribs) (Text replacement - "*Chest pain" to "*Chest pain")

Background

  • Can occur de novo or in setting of psychiatric disorder (most commonly panic disorder)[1]

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
  • May feel the "urge to flee" or "sense of impending doom"

Differential Diagnosis

Acute dyspnea

Emergent

Pediatric-specific

Non-Emergent

Evaluation

  • Clinical diagnosis, based on history and physical exam.

Management

  • Reassurance and patient education
  • 1-2mg Lorazepam (Ativan) IV/IM

Disposition

  • Discharge

See Also

References

  1. 1.0 1.1 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.