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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19316
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have had these episodes over several years and, after a

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I have had these episodes over several years and, after a spell of nine months or so when they didn't occur, they returned a few months ago. They seem to be happening every two weeks or so.
It starts with tightening of the chest and very rapid heartbeat. I don't feel any acute pain, rather the restriction causing difficulty breathing and sudden weakness. If I can, I take an aspirin and lie down. Then the following symptoms happen every time. Within one to two hours I have a bout of diarrhea; soon after, severe headache; and then I am very sick. It can take anything between a few hours and most of the day to start to recover. Either way, I am completely 'rung out ' the next day. The most difficult thing for me to cope with is how frightening I find it. I am not a cowardly person, but I live alone and find these episodes alarming. I have absolutely no qualms about living alone and enjoy life very much.
My doctor told me two years ago that these were the symptoms of panic attacks, although she felt this was a misnomer and certainly I can't link them to any anxiety.
Tests at the cardiac clinic two years ago didn't identify 'anything too irregular '.
I have just had one of these episodes again early yesterday, and I wondered if you could give me any reassurance at all.
I apologise for the length of this message but I wanted to give you as much information as possible.
Many thanks,
Margaret McBride.

Hello from JustAnswer.

It is very possible that these episodes could be anxiety or panic attacks, even though they are not associated with any particular separate sensation of anxiety. However, since there is no direct test to prove an anxiety or panic attack, the diagnosis is made by an evaluation to exclude other possible causes of the symptoms or empiric treatment of anxiety/panic.

The most important condition to exclude is heart disease, as this would be the most serious condition that could cause these symptoms. So, it is very reassuring that a cardiac evaluation has already been done and found no significant disease.

Once heart disease has been excluded, then there are two options. Either the doctor could start a medicine for anxiety to see if the symptoms improve or further evaluation to exclude diseases of the lungs or GI tract can be done. Since your doctor has already expressed that these are due to anxiety/panic, it would be reasonable to use an anxiety medicine to see if the symptoms improve, such as an SSRI antidepressant.

Regardless of which approach is taken, you can be reassured that there is not a serious cause of these symptoms.

If I can provide any additional information, please let me know.

Dr. D. Love and other Medical Specialists are ready to help you
Customer: replied 1 year ago.
It is reassuring that you feel there is nothing serious to worry about. I will probably follow up on the two possibilities you describe, including investigation of the recurring cough I have. Thank you for your help, doctor.