BMJ Case Reports 2013; doi:10.1136/bcr-2013-009307

Panic-related hyperventilation resulting in hypophosphataemia and a high lactate

  1. Tom Pickett
  1. Department of Acute Medicine, Gloucestershire Royal Hospital, Gloucester, UK
  1. Correspondence to Dr Nicolas Suarez, suarez.nick{at}


A 22-year-old lady presented to the emergency department with dyspnoea and pleuritic chest pain. Life-threatening asthma, pulmonary embolus and pneumothorax were all excluded. However, investigations did show an unexplained hypophosphataemia and raised lactate, both of which were subsequently attributed to hyperventilation with a component of panic. Here we explore the mechanism of these findings and the management of hypophosphataemia.

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