What are the manifestations of panic attacks?

  Panic attack, also known as acute anxiety attack, is a major manifestation of anxiety disorder (panic disorder). Its basic characteristic is the unpredictable recurrence of panic attacks in the absence of objective danger or without obvious fixed triggers, and it is often clinically misdiagnosed with heart disease. These attacks are not limited to any specific context and are unpredictable. The typical manifestation of an attack is a sudden, intense fear of dying (near death) or losing one’s mind (loss of control), which is unbearable for the patient during daily activities. At the same time, the patient feels palpitations, as if the heart is about to jump out of the mouth, often accompanied by chest tightness, chest pain, shortness of breath, throat blockage, and a feeling of suffocation. Patients feel as if they are on the verge of the end, so they scream, call for help or run outside. Some patients may have significant autonomic symptoms. Neurological symptoms such as hyperventilation, dizziness, excessive sweating, facial flushing or pallor, cushy tremors, numbness in the arms and legs, gastrointestinal discomfort, and other painful experiences such as depersonalization and dissolution of reality may also be present.  Panic attacks usually have a rapid onset and termination, peaking within 10 minutes and generally not more than 1 hour. The patient is conscious during the seizure and can recall the seizure afterwards. Patients may think they are going to die, fear a heart attack or stroke, or be afraid they will go crazy during the attack. Patients who have had several previous panic attacks may experience near-death fears due to this intense discomfort, even though they know they will be unharmed after the attack. The interval between attacks has no significant symptoms other than the fear of having another attack. However, most patients are nervous and anxious during the interictal period due to the fear of having another attack, and may experience anticipatory anxiety, thus often actively avoiding some activities, such as not wanting to go out alone.