A 33-year-old woman comes to the emergency department 30 minutes after the sudden onset of chest pain, palpitations, shortness of breath, numbness and tingling in both arms, and fear of going crazy. She has visited local emergency departments several times over the past 3 months for similar symptoms that resolved within 1 hour. She uses an oral contraceptive. She drinks two beers daily and six beers on the weekend. She has no history of medical problems. Her mother and sisters have a history of anxiety. Her pulse is 90/min, respirations are 18/min, and blood pressure is 130/90 mm Hg. Physical examination, laboratory studies, and an ECG show no abnormalities. Which of the following is the most likely cause of anxiety?(A) Alcohol withdrawal(B) Coronary insufficiency(C) Hyperthyroidism(D) Hypoglycemia(E) Major depressive disorder(F) Panic disorder(G) Paroxysmal atrial tachycardia(H) Pheochromocytoma(I) Post-traumatic stress disorder(J) Pulmonary embolus(K) Somatization disorder

Panic disorder is characterized by sudden extreme panic attacks caused due to intense fear or terror. Some of the symptoms include perspiration, hyperventilation, shortness of breath, chest pain, trembling, dizziness, numbness, intense uncontrollable fear and a feeling of impending doom. Panic disorder is a type of anxiety disorder and is often hereditary.

Therefore, the most likely cause of her anxiety is panic disorder.