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Suggest Treatment For Shortness Of Breath Due To Panic Disorder

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Posted on Fri, 28 Mar 2014
Question: I was under huge stress and anxiety for the last 3 years. My dad was being treated for late stage metastatic prostate cancer. Also I had the phobia that I might have cancer myself. Dad dies on 2nd December 2013. After dad's rituals were over I suddenly started getting chest tightness, shortness of breath,and mild to moderate chest pain .. I also felt tightness in throat and tingling in shoulders arms and hands and legs as well. I also felt dizzy and weak. I was worried and went to the ER and did a whole body check. The tests included ECG, Chest X-ray, EKG, TMT, PFT, complete blood work, Trop-T .. All results came normal twice with a gap of 1 month .. I was in touch with a general physician, a cardiologist and a pulmonologist and all of them said that it was due to stress and anxiety. The only anomaly was elevated cholesterol, triglycerides, uric acid and SGPT (fatty liver history) in the 1st test. I was prescribed Zabesta 2.5 once a day, Rozavel 5.0 once a day, Udiliv 150 mg once a day, Evion 400 once a day and Trika as and when required. The 2nd test showed that my cholesterol, TG, uric acid and SGPT are well within normal limits. So now I am only on Zabesta 2.5mg once a day, Rozavel 5.0 once a day and Trika (as and when required). I feel definitely better than before in the sense that the chest pain has almost disappeared, the dizzy feel is very very infrequent (comes only in times of stress it seems).. But I still have occasional SOB (only when taking a very deep breath) and a mild throat and chest tightness (although not continuous) ... Seems like things are getting into shape... Request your advice please ..
doctor
Answered by Dr. Lav Kaushik (3 hours later)
Brief Answer: Panic attacks secondary to stress Detailed Answer: Hello. Welcome to Healthcare Magic. Well it seems like you have been suffering from what is described as Panic disorder where in a person starts getting sudden episodes of anxiety/ panic attacks having core features of chest tightness, fearfulness, feeling of impending doom and loosing control over self, shortness of breath and choking sensation, etc. You see to have developed this type of anxiety disorder ( i.e is panic disorder ) as a result of extreme stress and shock from seeing your father dying of cancer which invariably had given you some food of thought for relating it to your own future chances of contracting it. All of this had evoked a sense of panic within you which culminated into such a sudden episode followed by more of it. Now it seems like your nerves are settling both with the help of trika as well with passage of time and your return to your normal busy life, so i feel that in the near future you shall be able to outgrow this condition of panic disorder but as of now you should continue taking trika on PRN basis that is as and when required basis. I hope this helps. If there is any further query/doubt in your mind please feel free to ask. If there is no query that you will want to ask then kindly rate the answer and close the conversation. Thanks for choosing Healthcare Magic. Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Lav Kaushik (31 minutes later)
Thanks for your prompt reciprocation Sir .. So it seems that it's not an issue of heart or lung like artery block or lung cancer right ? The cardiologist and pulmonologist also said the same ... But there always remained a hitch in my mind that they might be wrong .. such was the obsession ... But day by day I am feeling that it just might be my illusion .. I also did a FOL and found no tumours in my throat .. just to confirm .. Thanks, XXXX
doctor
Answered by Dr. Lav Kaushik (1 hour later)
Brief Answer: Follow up Detailed Answer: Dear XXXX, your symptoms are more likely to be psychological in origin and there does not seem to be any organic cause behind them, be it heart or lungs or any other organ for that matter, so kindly relax and try to concentrate on other important things in your life. You have now got yourself evaluated and re-evaluated and also got a second and a third opinion from different specialists, so there is no need to worry. I hope this sums up everything. Wish you all the best. Please kindly close this conversation and rate the answer if you have no further query / doubt to ask. Take care and we thank you for using our service. Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Lav Kaushik (17 hours later)
Dear Sir, This is in continuation with our preceding discussion (Please refer the trail). I just want advise from you whether I should go ahead a do another chest x-ray and echo and then settle down. Or whether I should just forget about it right away and get on with my work. Kindly advise. The 1st x-ray/echo was done on 18th December 2013 and the 2nd was done on 15th XXXXXXX 2014 and both came normal. My health is definitely much better than before. Just that slight SOB sand chest & throat tightness lingers on occasionally but that too also seems on the decline. I also had fatigue which has disappeared for the last 7 to 10 days atet I came back from an official trip Thanks, XXXX
doctor
Answered by Dr. Lav Kaushik (16 hours later)
Brief Answer: Follow up. Detailed Answer: Hello. Thanks for the follow up question. Well, there is no need at all to go again for echo or chest x-ray or any other investigation since twice the same investigations which have been done just recently have ruled out any significant organic cause and so you should just accept that there is no problem at all and you shall try to get on with your life as usual without having any ounce of doubt in your mind as you have been so far thoroughly evaluated with no apparent problem having come to notice. I hope this puts to rest all your doubts and queries, kindly find closure on this and start concentrating on important issues which I am sure have been ignored by you due to your preoccupation with your health. The symptoms that are remaining as of now will slowly go away as more time passes by. I hope this helps. If there is no further query that you want to ask then kindly rate the answer and close this conversation. Wish you all the best and speedy recovery. Warm Regards
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Lav Kaushik

Psychiatrist

Practicing since :2004

Answered : 112 Questions

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Suggest Treatment For Shortness Of Breath Due To Panic Disorder

Brief Answer: Panic attacks secondary to stress Detailed Answer: Hello. Welcome to Healthcare Magic. Well it seems like you have been suffering from what is described as Panic disorder where in a person starts getting sudden episodes of anxiety/ panic attacks having core features of chest tightness, fearfulness, feeling of impending doom and loosing control over self, shortness of breath and choking sensation, etc. You see to have developed this type of anxiety disorder ( i.e is panic disorder ) as a result of extreme stress and shock from seeing your father dying of cancer which invariably had given you some food of thought for relating it to your own future chances of contracting it. All of this had evoked a sense of panic within you which culminated into such a sudden episode followed by more of it. Now it seems like your nerves are settling both with the help of trika as well with passage of time and your return to your normal busy life, so i feel that in the near future you shall be able to outgrow this condition of panic disorder but as of now you should continue taking trika on PRN basis that is as and when required basis. I hope this helps. If there is any further query/doubt in your mind please feel free to ask. If there is no query that you will want to ask then kindly rate the answer and close the conversation. Thanks for choosing Healthcare Magic. Regards