Dave is a 41-year-old male who was referred by his primary care physician after presenting to the ER with difficulty breathing. Dave’s physician was unable to find a medical explanation for his...

Dave is a 41-year-old male who was referred by his primary care physician

after presenting to the ER with difficulty breathing. Dave’s physician was

unable to find a medical explanation for his symptoms, which left Dave

feeling confused, stressed, and angry. Over the last 6 months, Dave has had

several instances where he felt an intense fear that would reach a peak within

a few minutes. During these instances, he would also experience sweating,

heart palpitations, chest pain and discomfort, and shortness of breath. At

times, Dave worried that might die. As a result, Dave has persistent worry

about having another attack. In addition, he has begun to avoid unfamiliar

places and people where it may be difficult to get help in the event of another

panic attack. The panic and associated avoidance are significantly impacting

Dave’s life as he has been turning down social invitations, making excuses to

stay at home whenever possible, and relying on his wife to drive their

children to their various activities. Although she was understanding at first,

Dave’s wife has grown frustrated with what she perceives as his irrational

fear of panic attacks

can you identify any comorbidities?