Panic Attack

Panic Attack is a topic covered in the 5-Minute Emergency Consult.

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  • Characteristic, acute episodes of physical symptoms and intense fear that rapidly peak within 10 min and resolve in∼20 min
  • There may be a nonfearful variant in medical patients.

Panic Disorder
  • Recurrent, unexpected panic attacks with ≥1 mo of persistence:
    • Concerns about having another attack
    • Worry about the implications or consequences of the attacks
    • Behavioral change, such as phobic avoidance, related to the attacks
    • With or without agoraphobia = anxiety related to fear of escape
  • Episodic, recurrent, or chronic attacks
  • Frequently comorbid with depression, substance abuse, disability, suicidal tendency

  • Probably genetic
  • Family history of panic or anxiety is common
  • Altered serotonin- and benzodiazepine-receptor function


Limbic system, norepinephrine release, other neurotransmitters (e.g., serotonin) implicated, leading to “fight-or-flight” response

Risk Factors

  • Major life events in the year preceding onset
  • Family history of panic or anxiety
  • Childhood shyness or separation anxiety
  • May develop in the course of predisposing physical illness or cocaine abuse:
    • May persist after the illness or substance use has resolved
  • Twice as common in women

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