Exams and Tests

The typical panic attack can mimic many harmful conditions. The doctor must "think of the worst" to be sure not to miss an important diagnosis. At the doctor's office or emergency department, you can expect the doctor to take a thorough history and perform a thorough physical examination.

• In particular, the doctor will be concerned with the person's past medical history, past mental health history, and any surgery the person may have had.

• The doctor will inquire about medications the person is taking or has recently taken and in what dosage.

• The doctor will inquire about whether panic or anxiety illnesses "run in the family" and about any recent drug or alcohol use by the person. During the evaluation for an illness is not the time to be untruthful about drug or alcohol habits because both of these factors are critical in the evaluation.

• Also, the doctor is likely to inquire about caffeine intake and any over-the-counter or herbal medicines taken.

• A physical exam will generally consist of a head-to-toe check of all the vital organ systems. The doctor will listen to the heart and lungs and may perform a brief neurologic exam designed to make sure the brain is functioning properly.

• The doctor will use the best judgment regarding the necessity of ordering tests. Given the nature of the symptoms in a panic attack, the person will usually receive an ECG or heart tracing.

• Should the doctor feel concerned that the symptoms might be caused by a medical disorder, blood tests, urine tests, drug screens, and even x-rays or CT scans might be ordered.

• If the person has a family history of seizures or symptoms that are not typical for panic attack, a neurologist may be asked to evaluate the person. There is some overlap between the symptoms of panic attack and what are known as "partial seizures." Distinguishing between the two is important because the treatment for each is quite different. A neurologist, if consulted, will order an EEG (electroencephalogram) to check for seizure activity in the brain. This is a painless test but does require some time to complete (typically overnight).

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