Anxiety disorder

33 y/o female with chest pain, difficulty on breathing, and heart palpitation. diagnosis???

58 yrs old male presented with following complaints since last one month n has consulted various respective specialists for the same. Ophthalmologist, cardiologist, ENT surgeon, chest physician without pinning down specific diagnosis. 1.Initially for one minute patient can speak few sentences which we can understand but after a while his speech can't be apprehended.His tongue becomes heavy. 2.There is a partial ptosis of right eye. 3.Sometimes he becomes out of breath even at rest. 4.Sometimes he can't swallow solids even liquid accumulates in one side of oral cavity. 5.Diplopia..double vision esp.when he swirls around to see any objects either left or right side. 6.Sometimes complains of palpitations n heaviness of chest. These are few symptoms he narrated to me. His CT of brain is normal. Other consultants opinions also does not signify any specific condition. What is your interpretation of this case n further workout plan..? Below mentioned are two options but mine is different that I will reveal afterward. '

WHAT is a PANIC DISORDER ? Many a times, I was forced to go to my casualty to see patients with PD in the middle of the nights. Let me share the information about what I learnt. ! Panic disorder(PD) is a frequent and debilitating psychiatric condition associated with reduced Quality of life and impaired work performance. The condition is characterized by discrete periods of intense fear or discomfort often accompanied by somatic and/or cognitive symptoms. Genuine physical signs such as chest pain, palpitations and shortness of breath resembling the known symptoms of Acute Cardiac events are common. PD often remains undiagnosed or untreated. It is estimated up to 40% of Individuals with panic attacks never seek treatment of any kind. Around 30-40% of patients with chest pain and normal angiographic findings meet the diagnostic criteria of PD. Most of them get labelled as dyspepsia ironically. Between 30-50% of Individuals diagnosed with PD also suffer from Agoraphobia( fear of places and situations that might cause panic or helplessness or embarrassment ), but by itself the prevalence of agoraphobia is considerably higher. Typically onset of PD occurs between late adolescence and the early twenties, but I , myself has seen in premenopausal women very often. Currently the diagnosis of PD is mainly based on the Diagnostic and Statistical Manual of Mental Disorders ( DSM ), which is the standard system to classify mental disorders for clinical studies. The most important risk factor for the development of PD is family history of anxiety disorders. First degree relatives of subjects with PD have a 4-7 times greater risk of developing PD. Finally PD can be defined as an inherited biochemical disturbance in the overall function or structure of GABAergic, noradrenergic, serotoninergic and/or dopaminergic systems. It is generally agreed that treatment of PD is Long term, lasting minimally 1 year and often 3 yrs or longer. But then the treatment of PD can come only in my next post !

Female Patient age of 38 years BP 90/60 usually complain in a month or two weak Palpitations Restlessness chest pain refers to chest to left hands but there is no sweating During this she can't speak means voice absent Ghootan in her Gala painful Breathing during this she feels going to die and her abdomen is going to large day by day I also adv USG and ECG But she Provide only ECG To me I doubt she is suffering from heart disease and intra abdominal prob too but there is no complain of abdominal pain and nausea and vomiting yet Pizza DX And RX

15 female, long hands, mentally challenged. Obsessive compulsive disorder for washing hands. Hands have allergic dermatitis. Would like opinions on her genetic disorder. OCD and dermatitis is given. She has unusually long hands and is mentally challeneged since birth. Is there a syndrome (Marfans??) At work ?