Which diagnosis best explains an acute onset of palpitations with sweating and a normal ECG with a low pCO2 on ABG?

Enhance your readiness for the Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) 4 Exam. Utilize our flashcards and multiple-choice questions, complete with hints and explanations, to ace your upcoming test!

Multiple Choice

Which diagnosis best explains an acute onset of palpitations with sweating and a normal ECG with a low pCO2 on ABG?

Explanation:
An acute surge of anxiety triggers sympathetic overactivity, causing palpitations and sweating. If the person is hyperventilating, CO2 drops, which explains the low pCO2 on ABG. The normal ECG argues against a primary heart rhythm problem or myocardial injury, making a noncardiac panic/anxiety episode the best fit. Atrial fibrillation would show an irregular rhythm on ECG, and infarction would typically present with chest pain and ECG/troponin changes. Depressive neurosis is less associated with such an acute hyperventilatory response.

An acute surge of anxiety triggers sympathetic overactivity, causing palpitations and sweating. If the person is hyperventilating, CO2 drops, which explains the low pCO2 on ABG. The normal ECG argues against a primary heart rhythm problem or myocardial injury, making a noncardiac panic/anxiety episode the best fit. Atrial fibrillation would show an irregular rhythm on ECG, and infarction would typically present with chest pain and ECG/troponin changes. Depressive neurosis is less associated with such an acute hyperventilatory response.

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