A 60-year-old woman presents to the emergency department for severe anxiety for the past 3 days. She reports that the anxiety is persistent and started suddenly. She reports that she has been experiencing some additional stress at work recently, but primarily she has been having attacks where she feels breathless, perspires, and feels like she is going to die. She reports that she had an especially severe attack two days ago and since then she has been on edge and feeling anxious and out of breath. Vitals signs are significant for heart rate 115 beats/minute and oxygen saturation 84% on room air. On physical examination, the patient is sitting on the exam table leaning forward with a straight back, with her legs hanging off the edge of the table and her arms resting on her thighs. Cardiac examination reveals tachycardia, but the physical examination is otherwise unremarkable.
Which of the following is the most likely diagnosis?
- A) Acute stress disorder
- B) Anxiety disorder due to another medical condition
- C) Borderline personality disorder
- D) Malingering
- E) Panic disorder