Anxiety attack or not??

nurseangel78 · May 3, 2005

I was diagnosed with panic attacks a few years ago. I had been to the ER a couple of times. The doc did blood work, EKG, etc... and everything turned up normal. I felt as though I was having a heart attack, trouble breathing, heart palpatations, tingling hands and arms, I felt like I was going to die right then and there. But, thank goodness that I have been attack free for about a year now due to anti-depressant medication.

You may want to see another doctor for a second opinion, just to be sure what the underlying cause is. I wasn't under a lot of stress and I still developed panic attacks.

I wish you the best of luck and hope your husband gets well soon.

Tweety, BSN, RN · May 3, 2005

Strange that an EKG wasn't done. I would think that in addition to respiratory causes, which they seemed to have ruled, out they would consider cardiac also.

I'm not the expert on anxiety attacks of this nature, so take what I say with a grain of salt, but I would also have to insist on a cardiac workup.

Good luck.

hospitalstaph · May 3, 2005

Thanks so much for your replies! The NP that I normally go to worked in a cardiology office before going into family practice so I think that I may schedule an appt with her tommorow. I am just worried that we are overlooking something. With me in nursing school with three little ones you would think that I would be the one with anxiety attacks:)

Tracy

Liddle Noodnik · May 3, 2005

Hi,
I apoligize if anyone is offended that I am asking for professional opinions to a personal problem but we really need an educated opinion.
My husband has been having trouble breathing for the past two months. He just told me on Saturday night so I told him that he should see a dr. this week. Today it became much worse so he went to the ER. He says that he was having a very difficult time breathing and his hands and feet were numb to tingling. In the ER they did a chest X-ray and blood work. I believe from his decription that a blood gas test was done, but no EKG. The Dr told him that he is having an anxiety attack and prescribed Zanex. My hubby told the Dr repeatedly (as well as the nurse) that he was not under any unusual stress. My husband is 31 healthy, works out 4 times a week, is 5' 10", 170 Lbs. He does have ulcerative colitis but it is under control and he is not on meds for it. He has never been diagnosed with asthma but does have allergies.
Does this sound like anxiety to you or should we seek a second opinion? He is home now and is still having a hard time breathing although without the numbness in the extremities.
Thanks so much for any info!
Tracy

Hi Tracy, I'm not a doctor but I play one on TV. Seriously, your husband should follow up with a regular physician and be evaluated. It could be anxiety, it might not be. Better to go to the regular doctor.

Anxiety isn't necessarily because of a stressful life - it's physiological as well. I've had it for years. I don't take Xanax or anything like that because I've learned some coping skills and gotten off them. I AM on antidepressants though which may have some antianxiety properties.

If the doc thinks it IS anxiety, great - he too can learn how to override the sensitive nervous system - through counseling et al - in the process he would probably be seen by a psychiatrist who would lend a third opinion.

Or like you said, could be respiratory or allergies or anything...

Hope you find out soon and I know your hubby won't believe this but - it is NOTHING to be ashamed of and it is NOT a moral weakness.

There are tons of resources on the web that you can check out too. Good luck to you both!

rjflyn, ASN, RN · May 3, 2005

Being an ED nurse I am going to comment. Based on the complaint as noted he most likely wouldnt have gotten a EKG done in any ER I have worked in the last several years. Course I can't say that with 100% certainty as no family history is noted. Having seen MI in someone so young I will hedge and say that the original posters husband is not a cocaine of methamphetamine abuser- the most like cause of MI in someone so young without a family history. The key is the complaint of difficulty breathing with numb hands and feet, generally thats not going to get you an EKG, make that arms and hands then yes maybe or a 40 year old over wt man. It often varies with the ED, the doctor and even the experence level of the nurse taking care of the pt. Now if the pt had insisted in an EKG most certainly one would be done in most cases.

Not seeing the patient though its all conjecture.

Rj:rolleyes:

Nurse Ratched, RN · May 3, 2005

The only thing that walks through my brain is the possibility of anemia r/t his ulcerative colitis, but I think he'd notice if he was bleeding out, plus a CBC would've been part of any basic blood workup.

It has been an ugly spring pollen-wise- any chance that he is developing allergy-induced asthma?

NurseFirst · May 4, 2005

The only thing that walks through my brain is the possibility of anemia r/t his ulcerative colitis, but I think he'd notice if he was bleeding out, plus a CBC would've been part of any basic blood workup.
It has been an ugly spring pollen-wise- any chance that he is developing allergy-induced asthma?

On Monday I had an appt w/my doc and c/o persistent cough (along with another problem). Out comes these little devices--peak flow meters? Now, my 0-2 sat was 98%--but my peak flow was not so good (enough that my doc was willing to take the best out of 3...). Current working diagnosis: asthma (awaiting further pulmonary function tests.)

I'm surprised those cute devices don't get used more often--especially with the frequency with which adult onset asthma is now being diagnosed. (Of course, I don't know what the adult age distribution is--I am 55).

Has he tried the xanax? Has it helped? If the xanax isn't helping, and he is still short of breath, a fuller workup should be done. ERs really aren't designed to do exhaustive workups on problems unless they are life-threatening--and then it is to get the patient stabilized and transferred elsewhere (the floor, home, specialty care unit...). At least that's how they are *supposed* to work.

He may want to keep a diary to note when breathing is more difficult; when is it better? What makes it worse? What happens when he exercises? Etc. If he has allergies--could it possibly be associated to exposure to something--including something he's eaten.

Good luck and keep us posted,

NurseFirst

hospitalstaph · May 5, 2005

On Monday I had an appt w/my doc and c/o persistent cough (along with another problem). Out comes these little devices--peak flow meters? Now, my 0-2 sat was 98%--but my peak flow was not so good (enough that my doc was willing to take the best out of 3...). Current working diagnosis: asthma (awaiting further pulmonary function tests.)
I'm surprised those cute devices don't get used more often--especially with the frequency with which adult onset asthma is now being diagnosed. (Of course, I don't know what the adult age distribution is--I am 55).
Has he tried the xanax? Has it helped? If the xanax isn't helping, and he is still short of breath, a fuller workup should be done. ERs really aren't designed to do exhaustive workups on problems unless they are life-threatening--and then it is to get the patient stabilized and transferred elsewhere (the floor, home, specialty care unit...). At least that's how they are *supposed* to work.
He may want to keep a diary to note when breathing is more difficult; when is it better? What makes it worse? What happens when he exercises? Etc. If he has allergies--could it possibly be associated to exposure to something--including something he's eaten.
Good luck and keep us posted,
NurseFirst

Hi,

Yes he is currently on xanex and is getting no relief. This is now day three of this so called panic attack. He does regularly work out and his trouble breathing does not get worse. He does work in the heating and cooling field, so I am wondering if he may have been exposed to some strange mold. He is seeing a NP on Friday.

Thanks so much:)

Tracy

austin heart, BSN, RN · May 5, 2005

Being an ED nurse I am going to comment. Based on the complaint as noted he most likely wouldnt have gotten a EKG done in any ER I have worked in the last several years. Course I can't say that with 100% certainty as no family history is noted. Having seen MI in someone so young I will hedge and say that the original posters husband is not a cocaine of methamphetamine abuser- the most like cause of MI in someone so young without a family history. The key is the complaint of difficulty breathing with numb hands and feet, generally thats not going to get you an EKG, make that arms and hands then yes maybe or a 40 year old over wt man. It often varies with the ED, the doctor and even the experence level of the nurse taking care of the pt. Now if the pt had insisted in an EKG most certainly one would be done in most cases.
Not seeing the patient though its all conjecture.
Rj:rolleyes:

I agree with all of the above. He most likely wouldnt have gotten a EKG done in our ER either. Is he c/o of any chest pain? Sore throat, cough?

zenman · May 5, 2005

Hi,
I apoligize if anyone is offended that I am asking for professional opinions to a personal problem but we really need an educated opinion.
My husband has been having trouble breathing for the past two months. He just told me on Saturday night so I told him that he should see a dr. this week. Today it became much worse so he went to the ER. He says that he was having a very difficult time breathing and his hands and feet were numb to tingling.
Tracy

Anxiety=hyperventilation=hypocapnia=tingling in toes and fingers

UM Review RN, ASN, RN · May 5, 2005

Still, is it possible for an anxiety attack to last for days??? Why didn't the Xanax help?

Does your husband smoke? Does he drink caffeinated beverages?