Do panic attacks increase cardiac risk?

[Triana2]

Hello,
I am a woman of 26 years old, from Spain.I started having panic attacks when  I was 18,i dont get them very often but what scares me the most is my heart racing.What helped me to overcome this was the fact that I knew they were not life threatening, but I found a research showing that there are some relation between panic disorders and sudden death, due to the activation ot the simpathetic nerves of the heart that can predispose to ventricular arrhythmias....The doctor who checked my heart(my ECGs are fine)told me that it is OK ,that i dont have to worry about.I dont smoke,eat very healthy, my BP is normally 110-70 and my heart rate about 60 but, I am scared to death now, and I cant stop thinking about this,what can happen if i get a panic attack and I can't control it?Could I die from the tachycardia produced in a panic attack?Are there any cases of people killed by a panic attack?.Thanks for your help.

[Cleveland Clinic]

Triana,

While Ive never had a panic attack, Ive witnessed quite a few and have close friends that suffer from the disorder. The primary problem is the feelings induced by the attack which increase the anxiety level resulting in a high adreniline state causing the resultant tachycardia and feelings.  

At your age you have little to worry about with your heart during these episodes.  Your focus should be more on triggers for your anxiety and dealing with them. Unfortunately, people often focus their worry on the symptoms of the panic attack which can often lead to more anxiety.  What you are going through is natural but you should really continue counseling and therapy with your anxiety issues.

good luck

[tickertock]

This is a great question, it will be very interesting to see the doctor's reply, though I think occasional panic attacks will make you feel like you're dying they are not life threatening unless you probably have an undiagnosed cardiac condition. I think frequent panic attacks and generalized anxiety states for a long time can adversely affect ones overall health such as rising blood pressure, weight gain from fear of exercise and bad health habits in general that make you more prone to developing significant health problems, other than that I personally don't think panic attacks can cause sudden death unless there is an undiagnosed cardiac problem present, just my personal opinion only.

[heartygirl]

I am so glad you asked this question, this is something that bothers me a lot - I know everyone SAYS that panic attacks can't harm you, but when you have a heart rate that goes up to 180 during an attack it is hard to believe that "it can't hurt you".  I eagerly await the Dr's reply to this one.

[Texiss]

I'll be keeping an eye on this thread also!  It is impossible to "relax" enough to stop an attack of tachycardia...and once the adrenaline from the panic attack kicks in it can be very scary. I don't think people, even those closest to us, can understand why we can't just follow their advice to "calm down" when it happens. Even the reassurance from doctors that it is not a life-threatening condition doesn't help much in the midst of an attack.  

Tex

[Konopka1955]

Hi,  Might I suggest you do some 'searches' on this through this web.  There are so many questions regarding this same exact problem and I think the doctors have answered it a hundred times over.  Of course one more time won't hurt.   But if all the doctors in the world told you that you were fine.   Would you believe them?  Would you believe what the doctor here tells you?  What is it you really want?  Ask yourself - what is it I really want.  Assurance that I will never die ?   No doctor can do that.  I think your asking that they have a crystal ball and tell you that your fine.  Do you want to be treated for possible sudden cardiac arrest and get an ICD for something that 'might' occur?  I just don't understand - so many ask the same question for these doctors.  Every time they answer the same way.  You can't provide accurate 'personal' medical diagnosis and treatment over the internet its just not possible and no doubt they'll tell you to see your doctor or make an appt with CCF.  I'm sorry.   But read the previous posts.  I think the doctors on this web have answered this question a million tmes.  Its whether you choose to believe them..  Obviously you don't....  

Best Wishes
Konopka

[netrox]

Well, I think *some* people who have "panic attacks" may not be panicking at all, they are experiencing abnormal heartbeat which causes them to panic. They should be checked for that. If they are determined to be healthy with no cardiac problems, they're probably panicky.

Almost everyone experienced palpitations without ill effects and moved on while people who have panic attacks tend to be constantly worried that it may cause the heart to be overworked for nothing. Their intense fear causes more panic attacks.

If you're constantly afraid, your blood pressure will go up, your stress hormones will be constantly flooded, and your heart rate goes up... you can be sure that it will double the risk of heart disease. The heart doesn't need that stress from excessive irrational fear.

When I take Xanax, I don't have tachycardia. I feel calm. I am not so fearful. When I am not taking it, I get all panicky and it's not pleasant.

Exercise helps control panic attacks. Studies show that vigorous exercise (the exercies that make your heart beat fast and make you sweat) for 20 minutes helped reduce their panic attacks signficantly.  

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14975776

-jeff

[upbeat63]

Just wanted to let you know that I've had panic disorder AND extremely high frequency PVCs for 22 years, starting around age 18 years old. Only wanted to let you know that, because I'm still here and don't expect to leave this beautiful earth any time soon. BUT in the begining, it sure felt like every day could be my last. Best of luck to you, it took a very compassionate doctor who "listened" to me and didn't just pat me on the head, before I felt comfortable. Maybe you just haven't found that one yet.

[fearfactor]

You asked, what do we want to be treated for possible SCD and have an ICD implanted?  Yes, I would do that in a "heartbeat" so to speak.  I have suffered with panic attacks since I was 12.  I have something called somatization disorder which is basically psychological issues that manifest themselves as physical ones - mine manifest as tachycardia and palpitations.  I am extremely terrified of SCD and can't live life normally anymore.  Would I get an ICD?  Absolutely, it would at least give me the reassurance that if something did happen, I could be saved.

[heartygirl]

I personally have never seen the question posed just like this  and I, for one, am GLAD that this person asked it.  You obviously have never had a panic attack.  I think it is a very valid question.  Furthermore, people need reassurance and support on this forum.  They don't need to be attacked, so if you have nothing nice or helpful to say, why don't you just not say anything?

[smc9975]

I to suffer from anxiety attacks which are made worse when I belive I am going to have a heart attack, the palpitations, sweating,increase in heart rate lead to more anxiety it is a very vivcious cycle, I have tried xanax and it didn't help so my cardiologist put me on ativan, 1 a day seems to keep me some what relaxed. people who never suffered from anxiety attacks don't understand what those who do go through and comments are taken very hard because you come off as mean spirited and insensitive, so yes I too am awaiting the reply from the dr.
just my 2 cents worth!

[netrox]

"My mother had extreme depression and suffered from panic attacks--she also had severe coronary artery disease. I saw her die from SCD.....she was in the hospital 1 day before for an arrythymia (afib) then dropped dead the next day."

I am sorry to hear that. Depression actually TRIPLES the risk of CAD. Those who only have PD (no depression) have twice the risk of developing CAD.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16204424&itool=iconabstr&query_hl=3&itool=pubmed_docsum

[I'mallheart]

great question. ive had this also for the past 3 yrs. today been really bad. laying in bed and see my whole body shake to my heart beat, neck veins can feel them, heart pound then you start thinking on them and gets worse. i think i am gonna take atenolol to help it. i hate it though, its so frustrating to have this and try to tell family members like my wife etc. and they dont understand and think i am crazy. its real symptoms and all. i wish i would have an EP STUDY did a stress test a few mos back and was okay. echo good. i just really hate this. its like you'll be fine for awhile then boom there back.
dave

[Lecah]

Hi. I e-mailed the Doctor with a similar question in October. I suffer from anxiety and panic disorder from PTSD (post traumatic stress disorder). Anyways, at the time I kept having nightmares, about 2 a night for a couple a nights a week. I was afraid that the adrenaline rush would cause tachy. and I wanted to know if it would cause more problems for me. The doctor replied that my irregular beats I felt after waking in a panic was probably from adrenaline or the panic attacks and doubted that the constant anxiety would precipitate an arrythmia. It was very comforting to hear his reply even though sometimes during other panic attacks it is far from my mind. I woke up 1 night and my heart was beating so fast I could not tell if it was anxiety or my heart for real. I called 911 and went in to a hospital and everything was fine and I went to my electrophysiologist the next day to see if my defibrillator detected an abnormal rhythm and it did not. I could not believe how fast my heart was racing and it took me awile to believe it was actually from the panic attack. I am in therapy for my anxiety and have xanax but that night I could not think straight to take the xanax and the other thing that bothered me was when ther EMS tech checked my pulse it was 70. I was in total disbelief but anyways I am looking forward to the Doctors reply and be well.

[jan]

My sis has panic attacks and I talk her through them.  Her behavior therapist recommended a book, "The Feeling Good Handbook".  She said it was helpful to her.  I bought a copy for myself and am glad I did.  When I was put on the Fentanyl Patch bad things happened to me and one of them was panic attacks.  I went right to the chapter about panic and anxiety and it really helped me.

To the one who posted about somatization, did the drs. thoroughly check you out?  Did they use a holter and/or event monitor or did they go right to the diag of somatization disorder?  I am not saying this to cause you to worry more, but maybe you have tachycardia simply because you have tachycardia.  Don't worry, they can be treated and are rarely a threat.  I am being treated for IST.  I was fortunate in that it was easy to catch, which is because I have tachy frequently and I am ok.  :o)

My heart goes out to those who suffer from panic attacks.

[fearfactor]

Hi, yes, I've had every heart test known to man, over and over again.  In fact, I'm wearing a heart monitor right now that I insisted my doctor put me on!  All the doctors say it is in my head, there is absolutely nothing wrong with my heart.  My tachycardia is definitely anxiety-related, as it never happens unless I'm keyed up or having a panic attack.  I also have heart palps that scare me to death but the doctors say are benign.  I just have a LOT of life stress and no outlets for it, so I guess my mind uses my body to let it all out!

[hawaii81]

sorry i dont mean to sound happy...but it's nice to know i'm not alone...i have had every test you could think of including angiogram and still not secure..been taking alprazolam on and off for the last half a year..i wont leave the house without it...i can relate to most of your post and sometimes smile or laugh when i read something close to what i go through..i would not wish this disorder on anyone...ALOHA...ONE DAY AT A TIME.....

[Lecah]

I couldn't bellieve it but I woke last night with what I guess was a nocturnal nightmare/panic attack and wound up calling 911. I started to calm down and asked my hubby to call and cancel the 911 call but he felt they should come and check me out just in case. When I woke up I was in bigeminy and then all of a sudden I felt a fluuter and my heart raced. I had just taken a xanax and it did not have time to work but that is when I lost it. As a cardiac patient I have nothing to fear from my PVC's, they are benign but when my heart races from panic and anxiety it scares the heck out of me!! I then cannot think rationally and call 911. I was blessed to have wonderful sweet EMT's last night who were thoughtful and understanding. I thought of this post after everything was said and done and today I went to my EP doc so they could interogate my defibrillator and it did not discharge. That was part of my nightmare and part reason for my ptsd. I have had it 13 years and had 2 malfunctions,infections and mishaps due to it and finally needed it this year because I had AV node reentry and since that incident my anxiety has come back with a vengence! Anyways, the doctor was right in that we focus on the panic and symptoms than the cause but for me in the heat of the moment I cannot think. I wish all those here that suffer from anxiety/panic and PVC's well. We are very thankful to have each other through this wonderful forum with excellent Doctors. Be well everyone!

[kristylu]

Everyone please read!! I am a big sufferer of panic attacks and anxiety disorder. I found a website that I believe saved my life. It's www.anxietycentre.com.  It gives the best explanation of what causes the symptons of anxiety and panic attacks. Once I read the cause of these symptons I IMMEDIATELY felt better. Basically when you worry about something your body automatically produces stress hormones (adrenaline) to prepare your body for whatever is about to occur. For example if you are in a car accident your heart starts racing, you may start to sweat or feel all clammy, you get the shakes.  When you have panic disorder your central nervous system is working over time and the more you worry the more stress hormone you are producing which in turn causes more and more anxiety. In short, if you stop worrying, your symptoms will stop. For people like me who have had anxiety daily for a long time it will take some time for your nervous system to return back to normal. I practice deep relaxation and breathing exercises daily and when I feel a symptom of panic or anxiety I tell myself it's only a symptom and it will go away. I do not let myself worry. I haven't ever felt better.

I don't want to make this too long so I'll stop now but on the website you have to sign up and become a member. I paid about $15 for a 6 month  membership but am so glad I did. I started feeling better as soon as I started reading. It's lenthy too. It took me about 4 or 5 days to read through all of the website. It has the best info out there on anxiety. They also have a forum to chat with other people.

Just thought this might help some of you who suffer from all of the same symptoms that I do with anxiety. Hope it helps!!

Thanks
Kristy

[netrox]

I hope this study will put an ease to your anxious mind:

"Ventricular ectopy in athletes - Don’t worry ... more good news!"

http://content.onlinejacc.org/cgi/content/full/40/3/453

From the abstract:

"Athletes, however, constitute a different but apparently healthy population. Twenty-four-hour continuous ambulatory ECG studies have shown a higher prevalence of VEBs (70%) and frequent and/or complex forms (25% to 63%) in athletic populations (20)."

Yep, you heard that right - 70% of athletes have PVCs and when they do have PVC's, they have more severe PVC's than normal people with PVC's!  

And it concludes:

"In the meantime, practicing physicians can continue to take solace in the good news that the subject with frequent and/or complex VEBs, who is thoroughly examined with conventional noninvasive cardiovascular diagnostic methods and found to have no evidence of structural cardiac disease, is at low risk of sudden cardiac death ... even if he or she is an athlete engaged in competitive sports."

So, take it easy! Don't fret over a few skipped beats!  

-jeff

[LynnSB]

as we say down south, lord knows I needed to read your comments today! NOOO, i'm not an athlete -- I used to be athletic, a runner, some 20 years ago until I let tachycardia and PVCs and PACs destroy my life ( actually part of it was that i had PSVT and was told I was basically nuts for most of that time and not believed when my heart would race to 200...) After my ablation, I don't have the very fast racing but the PACS and PVCs ( as witnessed by my questions and comments to this forum over the years) have continued to plague me and worry me to the point of dispair -- and to producing major anxiety problems. Yet again, however, it is very comforting to read any data supporting the idea that ectopic activity in a structurally sound heart isn't dangers. thanks for posting -- Lynn

[pugfriend]

When I was in my early 20's I started having panic attacks. They didn't know at first that's what it was. In the late 1960's you didn't hear much about it. Anyway, it almost ruiened my life. Finally I dicided that enough was enough and it took a lot of prayer and work but was able to get through it.  When I was in my 30's I began having heart flutter, mostly before a period. Didn't think much of it till it got a lot worse. A few years ago the palpitations sent me to the ER and, like most of you, everything was "normal".  My point. It seems like everything that goes on with me affects my heart. I have blamed everything from harmones to nerves. Sometimes the attacks happen for no apparent reason. This morning I am going to the dentist with an infected tooth and I had a few skipped beats. Maybe anxiety. When this happens, I feel like a bit of electricity runs through me and I almost taste it. Anybody else felt this way?  When I get a lot of PVC's it is a constant feeling of the same.  I do get tired of hearing that all is normal and not to worry, but that isn't easy.  The structure of the heart may be perfect, but if the pathways that make it beat are messed up, that isn't normal, otherwise it wouldn't make us feel so bad.  Maybe not dangerous but certainly uncomfortable. Just wanted to throw this in.

[rosetoes]

I too suffer from panic attacks which has recently landed me into the ER..heart rate over 200 and feeling like the end was approaching.  I was put of Toprol XL 50 mg and was told it takes from 7 to 10 days to be in full effect.  I have not had a paplitation, racing of my heart or double heart beats since.  

I did have anxiety terribly after the ER episode and also was given xanax to assist with the attacks.  I must admit it worked perfectly...no panic what so ever!  However, all that I read about xanax and addiction, I am now weaning myself off of them after 10 weeks of use at 1.5 mg per day.  

I am now down to .75mg per day and by the end of January I hope to be completely off of them.  I do have tremendous withdrawl syptoms (symptoms), but since I am on Toprol XL I feel comfortable that my heart rate is protected.  
I am 50 years old and have panic attacks since I was 20.  This was my first severe attach.  

If I can say one thing that I have learned....learn the deep breathing technique, it will stop some of panic before you peek with the panic attack.
Good luck