Hoa experienced ear pain and tinnitus, which were diagnosed as otitis media and mastoiditis, and treated on an outpatient basis. When she later developed palpitations, chest pain, and dizziness, she suspected a heart attack or stroke and sought hospital care.

Master, Doctor Nguyen An Khai from the Psychiatry Unit, Neuroscience Center, Tam Anh General Hospital Ho Chi Minh City, reported that Hoa was alert and responsive, but her mood was somewhat subdued, and her expression anxious. The patient frequently experienced a squeezing chest pain lasting about 10 seconds, accompanied by palpitations, a rapid heartbeat, numb limbs, and a feeling of losing control.

The results of Hoa's brain and cerebral blood vessel MRI showed no abnormalities. Her echocardiogram, coronary CT scan, and aortic ultrasound were all within normal limits, revealing no dangerous cardiac arrhythmias.

Doctors diagnosed the patient with panic disorder, accompanied by sleep disturbance and prolonged anxiety. The doctor explained that many people experiencing a panic attack often believe they are having a heart attack, a stroke, or a serious medical condition. In reality, this is an overactive alarm response from the brain to feelings of anxiety.

When the brain perceives the body to be in danger, the sympathetic nervous system activates, releasing stress hormones like adrenaline. This causes the heart to beat faster, increases breathing rate, tenses muscles, and alters sensations throughout the body. Patients may experience chest pain, shortness of breath, dizziness, numb limbs, and sweating.

"These symptoms are real, not imagined by the patient", Doctor Khai stated, adding that the cause is not in the heart or brain but rather a disorder in the nervous system's stress processing mechanism.

According to Doctor Khai, Hoa's ear, nose, and throat conditions were a trigger, causing her to constantly focus on her body. Each time she felt discomfort, she interpreted it negatively, fearing a severe illness. This negative thought process continued to activate the stress response, causing her heart to beat faster and leading to dizziness, intensifying the panic attacks.

Work pressure, prolonged stress, and lack of sleep can also trigger panic attacks in individuals prone to anxiety. The habit of constantly searching for health information online can also make many people more sensitive to bodily changes. Patients can easily fall into a vicious cycle: the more they worry, the more symptoms they experience, and the more symptoms they have, the more they fear a serious illness.

After a comprehensive evaluation, Hoa received multimodal treatment. This included psychological education, cognitive behavioral intervention, appropriate anti-anxiety medication, sleep support, treatment for her co-occurring ear, nose, and throat conditions, and repetitive transcranial magnetic stimulation (rTMS). This method uses magnetic fields to stimulate brain regions involved in emotion regulation and anxiety, helping to improve neural function, reduce stress levels, and improve sleep, thereby contributing to the control of panic attacks.

The doctor explained the mechanism of panic attack formation to the patient, guided her in recognizing early signs, reduced her habit of constantly checking her body, and helped her adjust pessimistic thoughts about her health.

Following treatment, Hoa's anxiety significantly decreased, she slept better, and symptoms of palpitations, chest pain, and dizziness were reduced. She continues to take medication, attends regular follow-up appointments, and manages stress to minimize the risk of recurrence.

Doctor Khai consults with Hoa during a follow-up visit. Photo: Tam Anh General Hospital

Doctor Khai noted that panic disorder is a common mental health condition but is often overlooked because its symptoms resemble many internal medicine illnesses. Patients frequently visit cardiology, respiratory, or neurology departments due to chest pain, palpitations, shortness of breath, and dizziness, yet all test results are normal.

Patients should seek medical attention if they experience symptoms such as prolonged anxiety, insomnia, frequent palpitations, or unexplained chest pain. Early treatment helps effectively control symptoms, improve quality of life, and prevent the condition from becoming chronic.

Trong Nghia