A 14-year-old girl is brought to the Emergency Department with a 20-minute history of difficulty...

This teenager presents with acute-onset dyspnea, paresthesias, and normal physical findings, consistent with a panic attack. Panic attacks often mimic cardiopulmonary pathology but are marked by symptoms like hyperventilation, tingling in the extremities, palpitations, and subjective air hunger with normal vitals and oxygenation.

Toronto Notes 2023 – Psychiatry:

“Panic attacks are characterized by sudden onset of intense fear or discomfort, accompanied by somatic symptoms such as dyspnea, paresthesias, tachycardia, and fear of losing control.”

MCCQE1 Objectives (Psychiatry > 71-3: Anxiety Disorders):

“Candidates must recognize panic attacks based on clinical features and differentiate them from cardiopulmonary conditions.”

Normal O2 saturation and physical exam rule out asthma or pericarditis. Cocaine use would present with more systemic toxicity. PSVT would cause consistent tachycardia.

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