A 30 year old lady do sudden onset breathlessness, anxiety, palpitation & feeling of impending doom. Physical examination is normal. What is the diagnosis
**Core Concept**
The patient's symptoms suggest a panic attack, which 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, chest discomfort, nausea, dizziness, derealization, fear of losing control, fear of dying, paresthesias, chills, and hot flashes.
**Why the Correct Answer is Right**
The patient's symptoms are classic for a panic attack, which is a hallmark of panic disorder. The sudden onset of symptoms, including breathlessness, anxiety, palpitation, and feeling of impending doom, in the absence of any physical findings on examination, is consistent with a panic attack. Panic attacks are often triggered by stress, anxiety, or other emotional stimuli, and can be a manifestation of an underlying anxiety disorder.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately describe the patient's symptoms. The patient's symptoms are not consistent with a cardiac condition, such as angina, which typically presents with chest pain or discomfort.
**Option B:** This option is incorrect because it is a term that refers to a condition characterized by a sudden, severe headache, often accompanied by nausea and vomiting. Migraine does not typically present with the constellation of symptoms described in the patient.
**Option C:** This option is incorrect because it does not accurately describe the patient's symptoms. The patient's symptoms are not consistent with a psychiatric condition, such as psychosis, which typically presents with hallucinations, delusions, or disorganized thinking.
**Option D:** This option is incorrect because it does not accurately describe the patient's symptoms. The patient's symptoms are not consistent with a medical condition, such as pneumonia, which typically presents with cough, fever, and chest pain.
**Clinical Pearl / High-Yield Fact**
Panic disorder is a common psychiatric condition that affects up to 6% of the general population, and is often comorbid with other psychiatric conditions, such as depression and anxiety disorders. Recognizing the symptoms of a panic attack is crucial in diagnosing and managing panic disorder.
**Correct Answer: C. This option is incorrect because it is a term that refers to a condition characterized by a sudden, severe headache, often accompanied by nausea and vomiting. Migraine does not typically present with the constellation of symptoms described in the patient.**