msyamp
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A 32-year-old married lawyer presents to the emergency department with a complaint of "having a heart attack." He explains he was "doing nothing particular" at home about 45 minutes ago when he began having chest pain with shortness of breath and nausea. His symptomsaked within ten minutes, and he "knew this was the big one." His wife noted he was "shaking and sweaty." His wife immediately brought
him to the hospitaI. He has no significant past medical history, takes no medications, and denies substance use. His family medical history is
significant for a paternal grandfather that "died of a massive heart attack" at age 56. Physical examination reveals an anxious diaphoretic
man taking short, shallow breaths. Vital signs, cardiac auscultation, ECG, and cardiac enzymes are completely normaI. The patient has been
to the emergency department 5 times in the last 6 weeks and apologizes for "the million dollar workup," but explains "every time it happens l
just know l am doomed to die."
Question 1 of 6
Which of the following is the most likely diagnosis?
/ A. Agoraphobia
/ B. Generalized anxiety disorder
/ C. Malingering
/ D. Panic disorder
/ E. Phobia
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| gogetit
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D
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| babli
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D
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| elisamik
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d,
symptoms occur within 10 min, no specific trigger, sob, and the feeling he's going to die.
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