title: [Panic attacks: a diagnosis to know in internal medicine. Analysis apropos of 11 patients and an attempt at a physiopathological explanation].
abstract: The authors report a series of 11 patients who consulted or were admitted to a hospital medical unit for organic symptomatology, especially hypertensive, diagnosed as panic attacks based on the criteria of the DSM III. Cardiovascular symptoms were dominant in 10 out of the 11 patients. In 7 cases, the symptoms were very suggestive of pheochromocytoma. Treatment based on tricyclic antidepressive drugs associated with behavioural therapy in 5 cases, led to the total regression of acute panic attacks in 9 out of 11 patients with a follow-up period ranging from 1 to 2 years. However, it did not prevent 2 of the patients from developing a chronic anxiety state. After reviewing the principal clinical features of panic attacks, the authors discuss their underlying physiopathological mechanisms. The results of catecholamine metabolic studies in 2 out of 3 patients suggest the possible role of an inhibitor of catecho-o-methyl-transferase, but this requires confirmation by further studies. Panic attacks are very prevalent in the general population (2 to 5 p. 100). The diagnosis must be born in mind to avoid long and costly investigations, and for specific treatment to be instituted. The main risk is the development of chronic severe morbidity with serious socio-familial consequences.
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D002395:Catecholamines / Q000378:metabolism; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010200:Panic; D012189:Retrospective Studies
chemical_list: D000928:Antidepressive Agents; D002395:Catecholamines
vernacular_title: Attaques de panique: un diagnostic à connaître en médecine interne. Analyse à propos de onze malades et tentative d'explication physiopathologique.