Rosh Emergency Medicine Practice Test

What serious condition could present similarly to a panic attack in an adult, characterized by chest pain and shortness of breath?

1. Pulmonary embolism

2. Aortic dissection

3. Myocardial infarction

4. All of the above

The correct answer is: All of the above

All of the listed conditions—pulmonary embolism, aortic dissection, and myocardial infarction—can present with symptoms that overlap with those of a panic attack, particularly chest pain and shortness of breath. Pulmonary embolism can lead to sudden chest pain and difficulty breathing due to a blockage in the pulmonary artery, often presenting with anxiety-like symptoms as well. Aortic dissection, a life-threatening condition involving a tear in the aorta, commonly causes severe chest pain that may radiate to the back, and patients may feel an overwhelming sense of impending doom. Similarly, myocardial infarction, or a heart attack, frequently manifests with chest discomfort and breathlessness, along with other signs such as sweating or nausea. The overlapping presentation of these serious medical emergencies with panic attack symptoms highlights the importance of thorough assessment and differentiation in diagnosis. In emergency settings, distinguishing these conditions from panic attacks can be critical for effective management and timely intervention. Thus, recognizing that all these conditions could mimic the presentation of a panic attack justifies the choice that all the above-listed options are serious conditions with similar presentations.