Monday, May 13, 2013

Author Question: Panic Attacks

Becky asks:

My MC's ex-boyfriend to come back with not-so-good-but-not-outright-
bad intentions to try to force her to take him back. He's been leading a high-stress life-style (Dental School, top of his class, used to be an cyclist but stopped exercising, angry about no perfect job post school, turned-mean, etc.) and then she leaves him because he's so awful and after almost 9 years of waiting to get married and live happily ever after, he tell her he doesn't know if he really wants to be with her. Okay. That's the back story on him.

Basically, he shows up in the throws of a nervous breakdown/panic attack that looks a lot like a heart attack. And that's my question: Can a panic attack have similar/same symptoms of a heart attack? I want him to be hospitalized at least over night, so it needs to be bad enough to have to be monitored for 24+ hours, but not bad enough to kill him or leave him there long-term.

Jordyn Says:

As far as the scene, it can work medically. I think instead of a panic attack-- you should go with an arrhythmia called SVT (supraventricular tachycardia.) I've included some links for you. At its simplest, SVT is a super fast heart beat. For an adult-- it would be a sustained, unwavering heartbeat over 180 beats/min.

The reason to change it to this type of medical condition is if the medical team determines he had a panic attack-- he will not be observed overnight. However, if he had an arrhythmia for which he was hemodynamically unstable (low blood pressure)-- then observing overnight is warranted-- particularly if they converted him out and he went back into it.

When you have SVT-- it can feel like you're having a heart attack. Many of the symptoms can be the same. Chest pain. Pain down the left arm. Jaw pain. Difficulty breathing. Low blood pressure. Sweating (diaphoresis). Pale, cool, clammy skin.

I don't know if this is the direction you want to go but would be my suggestion.


  1. You're awesome, Jordyn. Wow - did I write that email in a hurry??? Sounds like I was the one with the panic attack - hee!

    I DID change it to SVT, after exploring your links. Made SOOO much more sense to do it that way.

    Thanks for posting this!

    1. Excellent! Glad my scenario gave you a good option to write about.

  2. Jordynn, I'd like to suggest something, based on personal experience. My case might be unusual, so it might NOT work with the book, but Becky's required scenario rang a bell with me.

    Last December, I started having shortness of breath and what felt like a racing heart. It wasn't the first time, but this time I had radiating pain, so I headed for the closest ER. I've had a panic attack, so I didn't think it was that. My EKG was clean. They apparently believed me, however, even though they couldn't detect anything right away. So they kept me overnight to run a series of tests, and they put me in an observation room.

    The verdict? Low potassium. $35,000 later, it turned out I needed a mineral supplement. The good news is that all those tests showed I have a perfectly healthy heart, with no blockages or other issues. That reassurance made me feel even better.

    1. Ramona-- that is a GREAT idea. I'm going to log it for future reference. I think I advised a previous author to perhaps use low sodium in and elderly person as a reason for their confusion. It is really surprising how sensitive your body is to swings in electrolytes. Excellent option!