What are the approach considerations in diagnosing panic disorder?

Updated: Mar 21, 2018
  • Author: Mohammed A Memon, MD; Chief Editor: Randon S Welton, MD  more...
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Answer

No invasive procedures are required to diagnose panic disorder, although they may be useful in eliminating other conditions in the differential diagnosis. As previously mentioned, history, collateral information, physical examination, and a mental status examination remain the diagnostic cornerstones for panic disorder.

Use electrocardiography (ECG) to assess for signs of ventricular preexcitation (short PR and delta wave), for short or long QT interval in patients with palpitations, and for ischemia, infarction, or pericarditis patterns in patients with chest pain. Outpatient Holter monitoring or transtelephonic event recording is rarely necessary but should be considered in patients with palpitations associated with syncope or near-syncope.

Patients who may be at risk for pulmonary embolism require appropriate testing (e.g., determination of D-dimer level, spiral CT scanning, ventilation-perfusion [V/Q] scanning, duplex Doppler/ultrasonography, or pulmonary angiography).


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