A patient presented in casualty with a history of sudden onset palpitation, sensation of impending doom and constriction in his chest. This lasted for about 10-15 minutes after which he became all right. What is the MOST likely diagnosis?
**Core Concept**
A panic attack is a discrete episode of intense fear or discomfort that reaches a peak within minutes and includes symptoms such as palpitations, sweating, trembling, shortness of breath, feeling of choking, and fear of losing control or dying. These symptoms are not in response to an actual danger or threat.
**Why the Correct Answer is Right**
The symptoms described by the patient, including sudden onset palpitations, sensation of impending doom, and constriction in the chest, are characteristic of a panic attack. Panic attacks are often triggered by specific situations or stimuli, but in this case, the duration of the episode (10-15 minutes) and the constellation of symptoms suggest a panic attack. The patient's symptoms resolved after a short period, which is consistent with the typical course of a panic attack.
**Why Each Wrong Option is Incorrect**
**Option A:** Phobias are intense, irrational fears of specific objects or situations, which do not typically present with the acute onset of physical symptoms described in the scenario.
**Option B:** Personality disorders are long-standing patterns of thought and behavior that are maladaptive and pervasive, and are not characterized by acute episodes of intense fear or discomfort.
**Option C:** Generalized Anxiety Disorder (GAD) is a chronic condition characterized by excessive worry about everyday things, which is not consistent with the acute onset and brief duration of symptoms described in the scenario.
**Clinical Pearl / High-Yield Fact**
Panic attacks often involve a fear of losing control or dying, which can be triggered by a variety of factors, including physical symptoms such as palpitations or shortness of breath. The key is to recognize the characteristic symptoms and duration of a panic attack, which can help diagnose the condition accurately.
**✓ Correct Answer: D. Panic attack**