A 41 years old female patient comes to AIIMS emergency with complains of flurry, palpitations, profuse sweating and sense of impending doom. The following test should be done in emergency to rule out organic causes:

Ans: C. ECG(Ref: Kaplan & Sadock 11/e p376; Niraj Ahuja 7/e p90)Most close differential of this condition is myocardial infarction, which can be differentiated by ECG in emergency.Panic disorder must be differentiated from a number of medical conditions that produce similar symptomatology.Panic attacks are associated with a variety of endocrinological disorders, including both hypo- and hypehyroid states, hyperparathyroidism, and pheochromocytomas.Episodic hypoglycemia associated with insulinomas can also produce panic-like states, as can primary neuropathological processes.Disorders of the cardiac and pulmonary systems, including arrhythmias, chronic obstructive pulmonary disease, and asthma, can produce autonomic symptoms and accompanying crescendo anxiety that can be difficult to distinguish from panic disorder.