Differential Diagnosis for Strider in a Patient Having an Anxiety Attack

• Single most likely diagnosis:
  • Hyperventilation: This is the most likely diagnosis because during an anxiety attack, patients often hyperventilate, leading to respiratory alkalosis and symptoms that can be mistaken for stridor, such as a sensation of difficulty breathing or a high-pitched sound while inhaling.
• Other Likely diagnoses:
  • Laryngospasm: This can occur in the context of an anxiety attack, where the vocal cords spasmodically close, potentially causing a high-pitched sound or sensation similar to stridor.
  • Vocal cord dysfunction: Similar to laryngospasm, this condition involves abnormal movement of the vocal cords, which can be triggered by anxiety and mimic stridor.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Epiglottitis: Although less common, epiglottitis is a life-threatening condition that can cause stridor. It's crucial to consider this diagnosis, especially if the patient has a high fever, severe sore throat, or difficulty swallowing.
  • Foreign body aspiration: This is another critical condition that can cause sudden onset of stridor, especially in children but also in adults, particularly if they were eating or playing with small objects during the anxiety attack.
• Rare diagnoses:
  • Paradoxical vocal fold movement: A rare condition where the vocal folds move inward during inhalation, which can cause stridor-like symptoms and could potentially be triggered or exacerbated by an anxiety attack.
  • Anaphylaxis: While anaphylaxis can cause stridor due to laryngeal edema, it is less likely to be mistaken for stridor in the context of an anxiety attack unless there are other clear signs of an allergic reaction.