Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The typical panic attack can mimic many harmful conditions. The doctor must "think of the worst" to be sure not to miss a diagnosis with a potentially more medically serious outcome. 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 history of any mental illness, and any surgery the person may have had. In addition to exploring whether the person suffers from any other mental illness, the practitioner often explores whether the panic attack sufferer has a specific anxiety disorder in addition to or instead of panic disorder, like post traumatic stress disorder (PTSD), phobias, obsessive compulsive disorder, or generalized anxiety disorder.
The doctor likely will inquire about medications the person is taking or has recently taken and in what dosage.
The health-care professional will usually ask about any specific life stress the person may be experiencing.
The doctor will inquire about whether panic or anxiety illnesses "run in the family" and about any recent use of alcohol or other drugs 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 his or her 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).