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You're the flight surgeon. Anxiety.

Jerome J Schulte1, David R Jones, Royden W Marsh

  • 1Department of Aerospace Medicine, USAF School of Aerospace Medicine, 2602 West Gate Rd., Brooks AFB, TX 78335-5252, USA.

Aviation, Space, and Environmental Medicine
|August 20, 2003
PubMed
Summary

Anxiety can mimic serious medical conditions like heart and neurological issues. Recognizing panic attacks triggered by hyperventilation is key for diagnosis and treatment, especially in professions like aviation.

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Area of Science:

  • Medical Mimicry
  • Psychiatry
  • Neurology

Background:

  • Anxiety disorders can present with symptoms that imitate cardiac and neurological conditions.
  • Research protocols often use hyperventilation or lactate infusion to induce panic attacks in susceptible individuals.

Observation:

  • Patients with panic disorder may experience panic attacks with minor physiological changes, such as decreased CO2 or increased lactate during mild exertion.
  • Hyperventilation during REM sleep can trigger panic attacks, mimicking paroxysmal nocturnal dyspnea.
  • Syncope resulting from panic-induced hyperventilation can be mistaken for seizures.

Findings:

  • Anxiety-induced symptoms can be misdiagnosed as dyspnea on exertion or seizures by unsuspecting physicians.
  • Panic-like anxiety in aircrew necessitates grounding due to safety concerns.

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Implications:

  • Early identification and treatment of anxiety disorders are crucial for accurate diagnosis and patient management.
  • Psychotherapy offers a good prognosis for individuals with panic disorder, often enabling a return to demanding professions like aviation.