Which physical findings suggest panic disorder?

Updated: Mar 27, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: David Bienenfeld, MD  more...
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Answer

No signs on physical examination are specific for panic disorder. The diagnosis is made primarily by history.

The patient may have an anxious appearance. A patient presenting in an acute state of panic can physically manifest any anticipated sign of an increased sympathetic state. Tachycardia and tachypnea are common; blood pressure and temperature may be within the reference range, though hypertension may occur as well. Tremors may be noted. Cool clammy skin may be observed. Hyperventilation may be difficult to detect by observing breathing because respiratory rate and tidal volume may appear normal. Patients may have frequent sighs or difficulty with breath holding. Reproduction of symptoms with overbreathing is unreliable. Chvostek sign, Trousseau sign, or overt carpopedal spasm may be present.

The remaining examination findings are typically normal in panic disorder. However, remember that panic disorder is largely a diagnosis of exclusion, and attention should be focused on the exclusion of other disorders.


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