Differential Diagnosis for 23 Year Old Female with New Onset Panic Attacks
Single Most Likely Diagnosis
- Panic Disorder: This is the most likely diagnosis given the new onset of daily panic attacks without a trigger. Panic disorder is characterized by recurrent, unexpected panic attacks and fear of experiencing another episode.
Other Likely Diagnoses
- Anxiety Disorder Due to Another Medical Condition: Certain medical conditions, such as hyperthyroidism, pheochromocytoma, or cardiovascular disease, can cause panic attacks. It's essential to rule out underlying medical conditions that may be contributing to the symptoms.
- Substance-Induced Anxiety Disorder: The use of substances like caffeine, amphetamines, or cocaine can trigger panic attacks. A thorough substance use history is necessary to consider this diagnosis.
- Post-Traumatic Stress Disorder (PTSD): Although the question doesn't mention a specific trigger, it's possible that the patient is experiencing panic attacks related to a traumatic event. A detailed history of traumatic experiences is crucial to assess for PTSD.
Do Not Miss Diagnoses
- Pheochromocytoma: This rare tumor of the adrenal gland can cause episodic hypertension, tachycardia, and panic-like symptoms. Although unlikely, missing this diagnosis can be life-threatening.
- Thyroid Storm: Hyperthyroidism can cause panic-like symptoms, and a thyroid storm is a life-threatening condition that requires immediate attention.
- Cardiac Conditions (e.g., Arrhythmias, Cardiac Valve Problems): Certain cardiac conditions can cause symptoms that mimic panic attacks, such as palpitations, shortness of breath, and chest pain. It's crucial to rule out cardiac causes, especially if the patient has a family history of cardiac disease.
Rare Diagnoses
- Temporal Lobe Seizures: In rare cases, temporal lobe seizures can manifest as panic-like symptoms, including intense fear, anxiety, and autonomic symptoms.
- Vestibular Disorders (e.g., Vestibular Migraine, Benign Paroxysmal Positional Vertigo): Certain vestibular disorders can cause panic-like symptoms, including vertigo, dizziness, and anxiety.
- Neurodegenerative Disorders (e.g., Multiple Sclerosis, Huntington's Disease): Although extremely rare, some neurodegenerative disorders can cause anxiety and panic-like symptoms as an early manifestation of the disease.