112k views
1 vote
A 23-year-old female who comes in for a sudden abrupt dizziness, sweating, shortness of breath, and nausea with her heart feeling as though it is beating out of her chest. She states that the episode lasted for 30 minutes and resolved shortly after being roomed at the emergency department. What is your top DDX and how do you treat?

a) Panic Attack; provide reassurance and cognitive-behavioral therapy
b) Myocardial Infarction; administer aspirin and nitroglycerin
c) Migraine; administer analgesics
d) Alcohol Withdrawal; administer benzodiazepines

User Kim Edgard
by
8.1k points

1 Answer

4 votes

Final answer:

The top differential diagnosis for the 23-year-old female presenting with symptoms of dizziness, sweating, shortness of breath, and nausea is a panic attack, which can be treated with reassurance and cognitive-behavioral therapy. A myocardial infarction should be considered as a secondary possibility due to the potential for atypical presentations in women.

Step-by-step explanation:

Differential Diagnosis for a 23-Year-Old Female with Acute Symptoms

The symptoms described by the 23-year-old female, such as sudden abrupt dizziness, sweating, shortness of breath, and nausea with an intense sensation that her heart is beating out of her chest, point to the potential diagnosis of a panic attack. A myocardial infarction (MI) should also be considered given the overlapping symptoms of dyspnea, diaphoresis, and anxiety, but it typically presents with retrosternal pain and may show more severe symptoms.

Given the acute presentation and subsequent resolution of symptoms upon arriving at the emergency department, this case aligns more closely with a panic attack. The top differential diagnosis (DDX) for this patient would be a panic attack, with the treatment focusing on providing reassurance and engaging in cognitive-behavioral therapy (CBT). While myocardial infarction is less likely in a young female without chest pain, it is important to consider it as a secondary possibility because women can have atypical presentations of heart attacks, such as not experiencing the classic left arm pain seen in males.

User Rendy Del Rosario
by
8.4k points
Welcome to QAmmunity.org, where you can ask questions and receive answers from other members of our community.