34 year old female MS was brought in the clinic by relatives with severe palpitations, heaviness in chest and uneasiness (Ghabrahat) for last 10 minutes.

 

Her sister, who was accompanying her, had a thick file of about 100 documents with at least 30 ECGs and a worried look on her face.

“Doctor, she gets it every few days, all reports are normal. Now some one is suggesting angiography. Please help”.

On detailed history, it was apparent that this was no heart problem; she was suffering from Panic attacks.

What are panic attacks?

Panic attacks are episodes of intense fear, suddenly coming on accompanied by at least four or more bodily symptoms (i.e. heart palpitations, dizziness, shortness of breath or feelings of impending doom), which may last for variable duration from few minutes to hours. Panic attacks usually begin abruptly, may reach a peak within 10 to 20 minutes, but may continue for hours in some cases.

When one experiences intense fear or worry which begins very suddenly, is accompanied by palpitations, dizziness and breathlessness it is very likely a Panic attack. Panic attacks usually subside on its own. It is very disturbing as the person who gets such an attack may actually believe that he / she is having some sinister ailment like a heart attack. The person may also feel that he/ she is going to die and that worsens the panic. The sufferer is in such an anxious state that he may develop severe physical symptoms. Most sufferers go on the internet and search for the treatment of this sickness, which causes further distress and confusion.

What are the causes of a panic attack? One thing that must be clarified is that it is not the anxiety per se which causes the symptoms, but it is the physical sensations that makes one to believe that something wrong is going to happen. Anything can trigger anxiety.

Following causes have been shown to trigger panic attacks

• Breathing too rapidly or deep breathing or breathing in a shallow manner.
• Facing Extreme Stress situation
• Exaggeration of any symptoms, eg. someone having mild abdominal pain, but feeling that he / she is in great pain and may be suffering from dreaded disease.

The commonly found symptoms of panic attacks are

• Fast heartbeat
• Feeling like heart has been clasped
• Pain in the region of the heart i.e. left sided chest pain
• Extreme sweating
• Fast breathing
• Fainting or dizziness
• Extreme fear
• Bloated abdomen due to feeling of gas
• Feeling like one is about to die
• Ineffective urging to stool
• Fear that he may get an attack of panic

Management

• Counselling, psychotherapy and/ or medications.
• Identify your stressors and try to contain it.

Dr Shobha Ahuja, MBBS; FCGP, in family practice for over 30 years; is an ardent sports person; very active in inner wheel club; have presented papers at several conferences and writes regularly for consumers.