Management of Severe Hypophosphatemia in Patient Presenting With Panic Attack

We report the case of a 33-year-old woman brought by emergency medical services because of sudden-onset chest pressure, dyspnea, and subsequent panic attack with bilateral cramping of all extremities after albuterol trial. Cardiac causes were ruled out, and a comprehensive metabolic panel was significant for electrolyte abnormalities including hypokalemia and severe hypophosphatemia of 0.8 mg/dL. Hypophosphatemia is not commonly associated with panic attacks, although reports have established associations. This case reports the lowest phosphate level documented during an acute panic attack, highlighting the necessity of an increased suspicion for electrolyte derangements and ensuring prompt repletion to prevent further complications.