Something cardiac? Or just a Panic Attack?

[myboysrock000]

I was feeling pretty good one morning this week and was getting dressed to go to work when I felt nauseated and cold. I put on a jacket and sat down and waited a few minutes. It seemed to pass and then I felt a little hungry, like "empty stomach" feeling. So I was eating a granola bar and driving to work. The last bite made me feel sick again, and I started slow breathing to relax. Then I got a big palpitation-- it felt like a pause, then a big thump and then my heart started pounding really hard. My arms went numb and tingly and my palms were sweaty and I felt SOB, had a little chest pain. I was able to take slow breaths and managed to drive. Then I had another palpitation and aside from feeling scared, I actually felt a little better. I pulled into work and walked straight into the ED. I asked another RN to take my pulse and BP. HR was 90 and BP was 159/93. As usual, the few people who saw me trying to calm down in the breakroom said "Of course your BP was high, you were freaked out!" I realize that! But I felt pale and was shaking for HOURS! And my right hand stayed numb, tingly and cold to the touch for hours after, also.

I had SVT for the first time 2 months ago and am currently undergoing my cardio workup. My event monitor didn't catch anything, (so I'm preliminarily told). The ECHO is today. These palpitations have been getting worse. They cause me to get dizzy and they feel really scary.

It was suggested that I merely had a "panic attack" in the car. That is a tough pill to swallow, y'know? Which came first, the chicken or the egg? Because I know the palpitations, or whatever they are that I feel, are scary to me. But they come out of no where. Sometimes I'm just sitting down to eat, or driving in the car, or at the computer at work. They aren't while I'm yelling at my kids, or fighting with my husband, and they certainly weren't there 6 years ago when my dad died in front of me in Hospice care.

Ugh. Thanks for taking a moment to relate/discuss/support.

[zona365]

You should really weight all options before taking any medicine especially Beta-Blockers. Remember most of these medicines have bad side effects and might harm you more than your symptoms. I have palpitations too, same type of felling like you when I start to feel I'm riding in a elevator and then my heart starts to pund very hard for about minute or so. I have been on all possible tests and they found out that my heart is OK. I learned how to cope with these things. When they happen I yous think positive thats all, It is not going to kill me.
Always consider getting second opinion because you have cardiologists who tend to give these medicines like skittles.

[rilesnic]

I take a beta-blocker and it does help some, but I do still have panic attacks.  Like itdood said, facing the panic is the best way...I just don't seem to be at that point just yet.  I get the adrenaline surges too. I do believe we have to re-train our brain to overcome the fight-or-flight.  I do take xanax 0.25 as needed, but I only take it if it gets really bad.  Hang in there...

[myboysrock000]

OK, so I had another one today and I think I may be getting a grip on this whole Panic Attack thing. So what I think has happened is the SVT has triggered me to now have panic attacks? I have always had some genralized anxieties. They have come and gone over the years. I'll be "down" with it for a few weeks and finally come out on the other side and realize "That's what my problem has been!" This is the first I've had experience with these little 5-30min attacks with the physical symptoms. So scary, it feels so real, you really do think something is terribly wrong. Then i am sooooo tired afterward, like I just had a boxing match!
Any suggestions on getting help? Do I need medication? Or will it subside now that I have recognized it for what it is and maybe knowing it's not my heart will I stop panicking? Or is this still a diagnosis that needs medicating? I hear people on Beta blockers to help the tachycardia and adrenaline surges-- that sounds sooo nice! I would love to get this under control! I have a negative attitude toward needing psych meds or anti-depressants. I just don't feel like all of this is solely me being an "anxious female needing her zoloft" (I know...thats bad to say...but there is a stigma!) I mean, I really did have SVT, so I would love to not go into that again inthe future, it was very scary, too. A HR of 230 is really uncomfortable and scary and I am so thankful it ended in a few minutes.

[itdood]

I think there was some indicators there for a PA.  "My arms went tingly/numb/sweaty" is a classic hallmark and something I've experienced myself so I have a bit of personal perspective.

more clues are "chicken/egg", things like "out of the blue".  These are all common terms people use when describing a PA.

PAs are very much a chicken-egg thing.  People who have them tend to have a strong fear of a PA.  This is called fear of fear, so you can see why it would be a which-came-first type of ordeal.

The responses to this are extreme activation of the autonomic nervours system (ANS).  When this happens heart starts to race, sweat, extremetity blood vesels are restricted causing the tingly numbness...These are all fight or flight responses.

I've been studying PAs for many years.   I think the out of the blue variety are the ANS activiating for no reason at all.  It just happens.  I think there are also PAs that occur due to some sort of small stimulus and once that throught process of fear-of-fear kicks in it becomes a positive feedback loop (feeds on itself) and will grow to high intensity.

Your SVT might even be a component of this.  Remember SVT is a very broad spectrum of possible issues, some more bengin than others.

I finally learned to sqaush these back in my early 30s.  I learned how to seperate myself from the thoughts and observe them from the outside.  It wasn't easy to get tot his point, a lot of work.  By this time I started to actually crave having a PA so I could toy with it.  I know, sounds odd. Bottom line, I didn't fear fear anymore so the positive feedback loop was short-circuited.

[myboysrock000]

Thank you guys. I sit here and read the cardiac posts and convince myself that I have every right to have my heart checked out. And then I go onto the Anxiety/Panic posts and realize that it probably is "just" that. But it feels SO AWFUL.....and it does seem to come out of no where. I also feel these weird adrnaline surges sometimes. I also startle really easily and my heart will pound away and it's kind of annoying! If I am working out and already tachy, and someone yells in the gym or drops a weight, my heart pounds like mad and I get a really scared feeling. It's almost like I know mentally that I am not scared, but my body gets scared. Does that make sense? I would almost consider taking a med to stop all of this.
I did the Stress ECHO the other day, but they explained it only looked for coronary artery disease or a blockage which would cause the pain. So I am frustrated that they weren't checking for any prolapsed valves or regurg or the size of the heart or anything. So, I still feel like I don't have the answers I wanted. Monday I see the cardio doc FINALLY!

[rilesnic]

It does sound like you had a panic attack in the car.  A lot of similarities to my history, watching my mom die from a heart attack in the ER almost 9 years ago.  I do have tachy and PAC's which when they happen, if I am alone, I will go into a full blown panic attack and the after effects last for hours.  I believe my panic stems from my heart palps.  Everything you described is how I feel.  I am 37, 5'2" and 105 lbs. so I'm sure that is why I feel a lot of what I do.  I sometimes panic when I'm the passenger in a vehicle if we are in between towns and I know medical help is far away.  I know it's panic because I worry about having another panic attack.  The first one I ever had was while I was driving.  Let us know how your ECHO comes out.  I know it's a terrible feeling, but hang in there.  You are doing everything you should getting your heart checked out.  Best wishes to you.

[kayg33]

i was also told for a long time that maybe its anxiety. i knew it wasn't because i was never anxious or scared until after my heart would do its funny tricks, not before. being anxious or feeling nerves causes some palpitations but my palpitations were causing my anxiousness. my left hand would feel numb, my shoulder, my back, the left side of my neck all would hurt. i would get horrible hot flashes, stabbing pains in my ribs and a feeling of just complete pain in the center of my chest. sometimes if i have a burst of a fib, mainly they last only 3 to 5 seconds, my tongue will tingle and feel numb. weird i know. and very scary. i take meteprolol tartate 25mgs a day. it helps with keeping adrenaline, which you know is high when you get scared, from triggering your heart to pump faster which can in turn trigger underlying arrhythmias. my sister does have anxiety attacks and she and i would compare notes and i would always say to her that we are so different because her symptoms sounded nothing like mine. the doctors actually had me thinking it might be anxiety at one point early on. she was scared to drive her car, worried about night fall every evening, having crying episodes, and would even panic at stopping for red lights. all typical signs of panic attacks. NONE of that describes me or what i was feeling. all my symptoms seemed to stem from my heart and no where else.

[is_something_wrong]

I'm at the moment not able to answer so many questions, anyway I can try to give you a quick answer here.

It's lifted above all doubt that you had a panic attack. The real issue to discuss is whether your panic attack was caused by SVT (and being afraid of palpitations) or if it caused sinus tachycardia.

I believe you got freaked out by a PAC or a PVC, hence your heart rate hit the sky.The "thump" you feel is your first normal heart beat after a PAC/PVC or a SVT run.

As I've probably told you before, sinus tachycardia due to anxiety is also a SVT, and it's not possible to feel a difference between ectopic SVT and sinus SVT when the event is going on (except the fact that AVNRT, the most common SVT beside sinus tach) give a sensation of strong heart beats in your neck, but sinus tach can give this sensation during panic attacks too).

Anyway, the best way to find out is how the arrhythmia stops. SVT will stop instantly, making your heart rate drop from 150-200 to normal heart rate in a second. Sinus tach slows gradually. As your heart rate was 90 when you were monitored, you was obviously more relaxed but not completely.

I doubt this is ectopic SVT but to be sure you should ask for a / another holter monitoring.

[myboysrock000]

Sorry....I'm 33 year old female, non-smoker, rarely drink. I am average weight, and workout 3-5x a week. Have often experienced sudden pounding beats while exercising and will feel lightheaded. For example, yesterday in Spin my HR was up to 130's and I felt OK. And then my heart started beating really hard, and it makes me feel anxious and dizzy, and my montior shows my HR to still be 130's. And I feel like I have to slow down, so I do. It passes in a minute and I can start back up and my HR is back to the 130's and I feel OK again. It's so annoying, and I have dealt with that for the last year or so, and haven't gotten any feedback about what the heck that is.....