Wednesday, July 22, 2009

anxiety disorder

Patient was apparently well until July 2009, when she developed palpitation, fine tremor and shortness of breath. Regarding the palpitation, it was unexpected and acute in onset and appeared when she tries to lie down to sleep at night and last for twenty minutes. There was no aggravating factor but relieved with the presence of people around her. There was no known precipitating factor.

Regarding the shortness of breath, it was also acute in onset, appeared five minutes after the onset of palpitation and lasting for one minute. At that time, her daughter claimed that her breathing was very rapid. The shortness of breath is worsen on lying and relieved by sitting down. There was no chest pain, sweating, cyanosis, pallor, cough or fever.

She claimed that she also always had fine tremor while doing her daily activities and working. Sometimes, she had to stop for a while before continuing the work.

On further questioning, patient claimed that she always woke up from sleep at night and had a thought that she might dying during sleep. She was very afraid of getting a similar attack during the sleep every time she tries to lie down.


Okey, berdasarkan history patient ni, kebanyakkan symptom yang dia alami mcm medical punya symptom kan? For example palpitation, fine tremor, and shortness of breath but actually the last paragraph pointed the diagnosis toward anxiety disorder.

Orang normal pon akan mengalami symptom2 anxiety tapi yg tu normal la. So bila kita boleh kata yang anxiety tu tak normal, or there is anxiety disorder?

1. If the response is out of the proportion to the anxiety provoking stimuli
2. Anxiety symptoms are persistent and the duration is prolonged
3. Individual’s social function is affected
4. Presence of avoidance
5. No underlying organic problems

Types of anxiety disorder:

1. Generalized anxiety disorder – symptoms are not due to any particular stressor, often worries about daily matters
2. Panic disorder with/without agoraphobia
a. Sudden, severe, acute attack
b. Classical symptom: ‘feeling like fainting, dying, loss of control or going crazy’
3. Specific phobia – irrational fear of an object
4. Social phobia – Irrational fear of public situation
5. Obsessive compulsive disorder
6. Posttraumatic acute stress disorder (PTSD)

so agak2 apa diagnosis patient ni and kenapa?


emrullah on July 22, 2009 at 6:35 AM said...

panic disorder..then kene tnya lagi die ade fear of crowd or spaces tak..utk classify kan with or withput agoraphobia.

mardhiyyah on July 22, 2009 at 1:32 PM said...
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