Priya Anand

First behavioral health visit, referred after an emergency department evaluation for chest tightness and shortness of breath during what was ultimately diagnosed as a panic episode. Priya is a Virginia Tech junior, describes three similar episodes over the past two months, each around exam periods, and says she has been reluctant to tell her family given how her coursework is going.

She answered the intake questionnaire in short, minimizing terms and did not volunteer how disruptive the episodes have been to her class attendance. This is her first visit with no prior reading to compare against, but Haven's baseline shows anxiety and fatigue both above the range this practice typically sees at a first evaluation, closer to what the ER visit itself would suggest than to how she described it today.

Plan: chest CT from the ER visit reviewed below, no cardiopulmonary cause identified. Starting a brief course of cognitive behavioral therapy for panic, with a same week follow up rather than the standard two week interval given the baseline reading alongside the ER visit this month.