It was 4:36 a.m. She was in a cold sweat and having difficulty breathing. She felt as though she had run
a marathon. Fear swept through her-something terrible was going to happen. Panic-stricken, she
woke her husband, Jeremy.
"Denise, what is it? Is it a nightmare?"
"No, it's like I'm having an asthma attack. I feel lightheaded and I can't catch my breath. My heart feels
like it's beating a thousand times a minute."
Afraid to upset her husband further, Denise didn't tell him that an immense feeling of apprehension
suddenly overcame her. She got up to drink some water and waited for the anxiety to subside. Her
mind was racing. Jeremy had a family history of heart disease. This couldn't be happening to her. It
was his problem. A few months earlier Jeremy was diagnosed with coronary artery disease. He was
only 48 years old, the same age as Denise. The scare had encouraged him to gradually end years of
chain smoking and adopt a healthier lifestyle. He was currently working on giving up the occasional
cigarette for good.
"No," Denise thought to herself. "There's no way this was a sign of heart troubles. I didn't have a pain
in my chest, I'm physically fit, and I have no family history. There's just no way.
After assuring herself of this, Denise was somehow able to fall back asleep.
Questions:
1. How likely is this to be a heart problem? Asthma? Panic attack? Or...?
2. Why do you say this? What are the symptoms that are consistent with your preliminary
diagnosis? Is there anything unusual?