Rosh Psychiatry Board Practice Exam 2025 - Free Psychiatry Board Practice Questions and Study Guide

In this scenario, the most appropriate diagnosis is illness anxiety disorder. This condition is characterized by an excessive preoccupation with having or acquiring a serious illness, even in the absence of significant somatic symptoms. The patient's fear of heart problems represents a specific focus on health concerns, which is a hallmark of illness anxiety disorder.

Patients with illness anxiety disorder often engage in excessive health-related behaviors, such as frequently checking their body for signs of illness or seeking reassurance from healthcare providers. The focus is not just on physical symptoms but on the anxiety surrounding the possibility of being ill, leading them to misinterpret normal bodily sensations or minor symptoms as indicators of serious disease.

In contrast, generalized anxiety disorder typically involves excessive worry across various domains of life, not limited strictly to health. Panic disorder is characterized by recurrent unexpected panic attacks and the anxiety related to those panic attacks, rather than a preoccupation with illness. Somatic symptom disorder involves one or more physical symptoms that are distressing and may or may not be explained by a medical condition, but is distinct from the anxiety-centered concerns evident in illness anxiety disorder.

Thus, the pattern of excessive health-related behaviors and a specific fear centered on heart problems aligns closely with the diagnostic criteria for illness anxiety disorder.