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Panic Attack

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

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Basics

Description

  • 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

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

Etiology


Mechanism
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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Citation

Rosen, Peter, et al., editors. "Panic Attack." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307107/all/Panic_Attack.
Panic Attack. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307107/all/Panic_Attack. Accessed April 26, 2019.
Panic Attack. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307107/all/Panic_Attack
Panic Attack [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307107/all/Panic_Attack.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Panic Attack ID - 307107 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307107/all/Panic_Attack PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -