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Tachycardiamyopathy
Does anyone know anything about this condition? I was at my doctor’s today, after a REALLY bad episode of tachycardia, and I was telling him about how my heart can reach extremely high rates at certain times (in the 180s)! He said that due to the tests that I have had in the past, he is able to determine with confidence that my tachycardia is due to anxiety rather than to any physical problem. However, he contended that anxiety can be very hard on the body, and that it can even cause something called tachycardiamyopathy, in which the heart gets tired from beating rapidly for a prolonged period of time. I asked him how fast the heart would have to beat in order to trigger such a condition, and he said that it is different for everybody. Has anyone had any experience with this or heard anything about it? I am trying not to worry too much, to remember that although I may suffer from a very high heart rate at times, my heart rate is well below 100 in the normal way of things. I would just like to know what you all think …
I think the beta blockers would help you. They will help stop your heart from taking off like crazy, which in turn,, will help with your anxiety.
A good therapist can work miracles but it's not a quick fix. It can take a long time and is a lot of hard work on your part but it is worth it. I have struggled with anxiety disorders all my life, so I definitely understand where you are coming from, it can make your life totally miserable. And by the way, I take ativan when I need it and other than making me sleepy, I haven't had any adverse reactions to it. I have been taking it on a as needed basis for years and sometimes now am able to go long periods without taking any....so I'm definitely not addicted. You would not want to take it everyday for several weeks but taking it when you feel a panic attack coming on will not hurt.
A good therapist can work miracles but it's not a quick fix. It can take a long time and is a lot of hard work on your part but it is worth it. I have struggled with anxiety disorders all my life, so I definitely understand where you are coming from, it can make your life totally miserable. And by the way, I take ativan when I need it and other than making me sleepy, I haven't had any adverse reactions to it. I have been taking it on a as needed basis for years and sometimes now am able to go long periods without taking any....so I'm definitely not addicted. You would not want to take it everyday for several weeks but taking it when you feel a panic attack coming on will not hurt.
Yeah, I guess it's different for everyone. Still, I'm going to talk to my doctor about beta blockers and see what he thinks, whether this could be a better option than Atavin. We'll see!
I think you did mention your wife's case to me before. It inspires me to try to get to the root of my anxiety. As other people on here have said, I need to remember that the tachycardia is in my case the symptom and not the problem. I can take measures to treat the symptom, but the best thing to do is to treat the problem itself.
Actually, like your wife, I have a lot of family issues, including an always-be-perfect mother and an always-perfect sister. You're right: I should definitely talk to a psychiatrist and try to determine the extent to which these factors and others bear on my anxiety. It would feel so good to dig down deep and weed it out!
Actually, like your wife, I have a lot of family issues, including an always-be-perfect mother and an always-perfect sister. You're right: I should definitely talk to a psychiatrist and try to determine the extent to which these factors and others bear on my anxiety. It would feel so good to dig down deep and weed it out!
I think I mentioned this to you before. My wife of 40 years suffered from panic disorder from her late teens to late 30's. At first it was attributed to her "time of the month", and she was given tranquilizer to take during that time; Zactrin if I remember correctly. Then in the early 1980's she stumbled on a panic disorder article, and that started the actual process of recovery, not masking the symptoms.
My wife had perhaps 8 years of psychological counciling with a panic disorder specialist. She began a light drug therapy of Paroxetine (Paxil) and low dose Xanax (Alprazolam), The combination of these three things was like a miracle. The psychologist found the root of her disorder, and they worked on a solution. It can be different for every person, but in my wife's case her panic was "learned". It was a reaction to her over bearing, always-be-perfect mother. Once this reaction was learned, it was employed in other settings, a hot over crowded subway or bus, seated tightly in a church pew. Uncomfortness led to the same reaction that she had with her mother. All of these things had to be unraveled and worked on. My wife learned to stand up to her mother, but it was always a source of conflict. In our household, we say that it was a sorrowful day when my mother in law lassed away, when In fact, it was the happiest day for my wife as the source of her panic, and tensions was lifted forever.
I relate this to you as an example of what you need to do to find a cure. Again, I urge you to seek counciling with a specialist who deals only in panic disorder, ot anxiety neurosis. Together with this and possible drug therapy, you can find peace in your life.
My wife had perhaps 8 years of psychological counciling with a panic disorder specialist. She began a light drug therapy of Paroxetine (Paxil) and low dose Xanax (Alprazolam), The combination of these three things was like a miracle. The psychologist found the root of her disorder, and they worked on a solution. It can be different for every person, but in my wife's case her panic was "learned". It was a reaction to her over bearing, always-be-perfect mother. Once this reaction was learned, it was employed in other settings, a hot over crowded subway or bus, seated tightly in a church pew. Uncomfortness led to the same reaction that she had with her mother. All of these things had to be unraveled and worked on. My wife learned to stand up to her mother, but it was always a source of conflict. In our household, we say that it was a sorrowful day when my mother in law lassed away, when In fact, it was the happiest day for my wife as the source of her panic, and tensions was lifted forever.
I relate this to you as an example of what you need to do to find a cure. Again, I urge you to seek counciling with a specialist who deals only in panic disorder, ot anxiety neurosis. Together with this and possible drug therapy, you can find peace in your life.
I must say, what I describe is my experience, it doesn't have to be like that for everyone.
I've tried two beta blockers; metoprolol and propranolol. The first one is the most common, a so-called selective beta blocker. It slows the heart rate a bit and works fairly well against premature beats, but it has no effect on the anxiety. The second is a non-selective beta blocker, it does not reduce the blood pressure so much (as it has vaso-constrictive effect too), and it takes away almost all of the anxiety and racing heart rate.
What I take is 10 mg of propranolol, morning and afternoon (almost nothing). In my case, the anxiety is gone. But your doctor must give you the right dosage for you, if he decides that it's a good idea.
I've tried two beta blockers; metoprolol and propranolol. The first one is the most common, a so-called selective beta blocker. It slows the heart rate a bit and works fairly well against premature beats, but it has no effect on the anxiety. The second is a non-selective beta blocker, it does not reduce the blood pressure so much (as it has vaso-constrictive effect too), and it takes away almost all of the anxiety and racing heart rate.
What I take is 10 mg of propranolol, morning and afternoon (almost nothing). In my case, the anxiety is gone. But your doctor must give you the right dosage for you, if he decides that it's a good idea.
Well, now I'm starting to doubt more than ever the wisdom of taking a benzodiazepine! Even if you say it's a good idea, Achillea, I was doing more reading online and saw all the strange side effects that can occur, not to mention the possibility of addiction. I would much rather have something that works only on the heart, slowing my rate without making me feel funny. I'm sure beta blockers can have some minor side effects as well, but from what you say, it doesn't sound like they are likely to cause as many negative effects. My blood pressure is really low already so I don't really want to lower it, but if I took a small dose it might be OK. Maybe I should talk to my doctor again. Are beta blockers something that you take every day, or in the event of tachycardia?
I can't recommend anything, but in my country, a doctor would NEVER prescribe benzo for chronic anxiety, and for a young woman, not a chance in the world. The only time benzo is prescribed here, is in acute cases (like before taking a flight for those afraid of that), or while waiting for SSRI's to work.
They are not at all similar to a beta blocker. A beta blocker is not causing addiction, and it works by reducing the adrenaline effect on the heart.
The downside with so-called selective beta blockers (that only work on the heart), is 1) they may reduce blood pressure, which it sounds like you don't need, and 2) they are not very effective on anxiety. I use a small dosage of propranolol, a nonselective beta blocker and after I started that, I have never had a panic attack, or a racing heart. And not one side effect.
They are not at all similar to a beta blocker. A beta blocker is not causing addiction, and it works by reducing the adrenaline effect on the heart.
The downside with so-called selective beta blockers (that only work on the heart), is 1) they may reduce blood pressure, which it sounds like you don't need, and 2) they are not very effective on anxiety. I use a small dosage of propranolol, a nonselective beta blocker and after I started that, I have never had a panic attack, or a racing heart. And not one side effect.
Ativan is the trade name for Lorazepam, one of the benzodiazepine anti-anxiety drugs. It is very fast-acting and clears out fast, too. In my considerable experience with it, it has no 'hangover' effect, and it is an excellent *short term* treatment for acute anxiety, as when you are having a sudden panic attack. It reduces fright and it will lower the heart rate significantly if the tachycardia is due to that.
Go ahead and take it when you are scared out of your wits. There is no moral issue here; you have a medical condition. Low-dose Ativan has virtually no side effects, and you will feel better in about fifteen minutes. You are not going to turn into a werewolf or an addict in the short term.
However, in my experience, Ativan is NOT the solution for chronic anxiety. My suspicion is that the tendency towards panic and anxiety is genetic, and long-term care for it is as essential as it is for something like diabetes.
You are obviously an intelligent person, and I suggest you use your brain now to research psychiatrists in your area.
Believe me, the hardest part is making that first appointment. Shrinks are so good at what they do that they cut through all the crap in the first ten minutes, and after that, you will feel much more comfortable.
Probably you should also be aware that fear of medications is extremely common in anxious people, and yet it is treatable, too. Ironically enough, a little medication may be necessary for that.
Go ahead and take it when you are scared out of your wits. There is no moral issue here; you have a medical condition. Low-dose Ativan has virtually no side effects, and you will feel better in about fifteen minutes. You are not going to turn into a werewolf or an addict in the short term.
However, in my experience, Ativan is NOT the solution for chronic anxiety. My suspicion is that the tendency towards panic and anxiety is genetic, and long-term care for it is as essential as it is for something like diabetes.
You are obviously an intelligent person, and I suggest you use your brain now to research psychiatrists in your area.
Believe me, the hardest part is making that first appointment. Shrinks are so good at what they do that they cut through all the crap in the first ten minutes, and after that, you will feel much more comfortable.
Probably you should also be aware that fear of medications is extremely common in anxious people, and yet it is treatable, too. Ironically enough, a little medication may be necessary for that.
Achillea, you hit the nail on the head: it's a real catch-22. I worry about my heart, so my heart rate goes up, and because my heart rate goes up, I worry about my heart. Anxiety is truly a miserable thing. And you and the others are absolutely right in that even if the facts tell me I am unlikely to die from this condition, I don't always believe it. I know it, but I don't feel it, and that is the main problem here. And yes, I tend to spend WAY too much time obsessing about my heart, especially now when I don't have that much else to occupy me, and I know that it makes it worse. I need to try to stay busier and not to think about it, but it's so hard. I like your suggestion of seeing a psychiatrist rather than a psychologist. I think that would help alot.
is_something_wrong, thanks for the info. My doctor said the same thing you did, that because my high heart rate is caused by anxiety, my heart is surely beating nice and normal in my sleep, and therefore my average heart rate is much lower than I think. He said that it is in fact possible to have cardiomyopathy from sinus tachycardia, but you're right, I think he meant that this can happen if your anxiety levels are so high that your heart is constantly beating around 150 bpm or so, not that my periodically high rates are likely to cause it. I think he was indeed trying to scare me into treating my anxiety. He actually prescribed Atavin, which I am still debating whether or not to take. Is this similar to a beta blocker? As I understand, it has a similar effect of slowing the heart.
is_something_wrong, thanks for the info. My doctor said the same thing you did, that because my high heart rate is caused by anxiety, my heart is surely beating nice and normal in my sleep, and therefore my average heart rate is much lower than I think. He said that it is in fact possible to have cardiomyopathy from sinus tachycardia, but you're right, I think he meant that this can happen if your anxiety levels are so high that your heart is constantly beating around 150 bpm or so, not that my periodically high rates are likely to cause it. I think he was indeed trying to scare me into treating my anxiety. He actually prescribed Atavin, which I am still debating whether or not to take. Is this similar to a beta blocker? As I understand, it has a similar effect of slowing the heart.
I have horrible anxiety and panic disorder. A couple of years ago I was having really bad episodes that were landing me in the ER with regularity. It is almost impossible to control your anxiety when you feel like your heart is totally out of control and you can't trust it to do what it's supposed to. I finally had one of the nurses in the ER ask me if I didn't have anything else to think about except my heart. That really made me stop and think about what I was doing. I started to force myself to focus on other things, worry about other people instead of constantly wondering what my heart was going to do. It helped.
I would also suggest that you talk to your doctor about a beta blocker. That will help the anxiety as well as slowing down your heart and making the episodes of tachycardia go away or at least be less frequent. Beta blockers have saved what little bit of sanity I have left. They do have side effects but there are quite a few different ones and you can see which one effects you less. I take bystolic now and other than causing my blood pressure to get too low sometimes for the most part, I tolerate it fairly well. Way better than having my heart go all crazy.
I would also suggest that you talk to your doctor about a beta blocker. That will help the anxiety as well as slowing down your heart and making the episodes of tachycardia go away or at least be less frequent. Beta blockers have saved what little bit of sanity I have left. They do have side effects but there are quite a few different ones and you can see which one effects you less. I take bystolic now and other than causing my blood pressure to get too low sometimes for the most part, I tolerate it fairly well. Way better than having my heart go all crazy.
I've lived through it, depression and anxiety. Mostly on the anxiety side. I know exactly what you're talking about. I had panic disorder during my early 30s. I thought my life was over. It got better for me. I don't know if it was my actions to get control, or if it was passing phase for me.. I did cognitive behavior therapy and it was A LOT of homework. Intensive exposure therapy was amazing for me. It was like a religious epiphany for me when I overcame the boogey-man fears that stalked me.
I know exactly what this quote means, because I threw myself into the fire out of desperation.
"I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration.
I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path.
Where the fear has gone there will be nothing.
Only I will remain."
Frank Herbert, Dune
I know exactly what this quote means, because I threw myself into the fire out of desperation.
"I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration.
I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path.
Where the fear has gone there will be nothing.
Only I will remain."
Frank Herbert, Dune
Some facts first: (which you probably don't need to know, but as you have gotten familiar with this terms you may as well know them completely)
Tachycardiomyopathy (tachycardia-induced-cardiomyopathy) is one cause of dilated cardiomyopathy. There are a few others, alcoholic CM, diabetic CM, inflammatory CM, post-pregnancy CM, etc.. but it's just a description of the cause. The diagnosis is still dilated CM; an enlarged left ventricle with poor pumping capacity.
The heart muscle will always try to adjust to its environment. When people have high blood pressure, the heart adjusts by growing thicker walls (more muscle). The disadvantage is that the inner space is reduced. On the other hand, if your heart must keep a high cardiac output (rapid heart rhythm), it adjusts by increasing the inner space, but the problem is that the walls are thinner and weakened.
When the tachycardia goes away, the problem usually resolves (according to a doctor on this Expert forum.. I remember I asked him this question a couple of years ago).
Anyway..
I didn't know sinus tachycardia due to anxiety can cause this. It's seen in people with chronic tachycardia (almost all of them have unregulated atrial fibrillation) with a constant heart rate of 150 or so. I bet your heart rate is nice and slow at night, and when you are not worried. The heart rate is always slower than what you think. When I was really anxious and never felt my heart rate was below 90, I had a Holter test. My 24 hour average was 74 (and that included one hour of exercise).
Maybe your doctor was trying to motivate you to get your anxiety treated? I would also think that if your rapid heart rate was possibly dangerous to your heart, he would give you a beta blocker (which you may possibly consider anyway, as it slows the heart rate, and has also a mild effect against anxiety, especially the non-selective ones, they prevent the heart from racing).
Tachycardiomyopathy (tachycardia-induced-cardiomyopathy) is one cause of dilated cardiomyopathy. There are a few others, alcoholic CM, diabetic CM, inflammatory CM, post-pregnancy CM, etc.. but it's just a description of the cause. The diagnosis is still dilated CM; an enlarged left ventricle with poor pumping capacity.
The heart muscle will always try to adjust to its environment. When people have high blood pressure, the heart adjusts by growing thicker walls (more muscle). The disadvantage is that the inner space is reduced. On the other hand, if your heart must keep a high cardiac output (rapid heart rhythm), it adjusts by increasing the inner space, but the problem is that the walls are thinner and weakened.
When the tachycardia goes away, the problem usually resolves (according to a doctor on this Expert forum.. I remember I asked him this question a couple of years ago).
Anyway..
I didn't know sinus tachycardia due to anxiety can cause this. It's seen in people with chronic tachycardia (almost all of them have unregulated atrial fibrillation) with a constant heart rate of 150 or so. I bet your heart rate is nice and slow at night, and when you are not worried. The heart rate is always slower than what you think. When I was really anxious and never felt my heart rate was below 90, I had a Holter test. My 24 hour average was 74 (and that included one hour of exercise).
Maybe your doctor was trying to motivate you to get your anxiety treated? I would also think that if your rapid heart rate was possibly dangerous to your heart, he would give you a beta blocker (which you may possibly consider anyway, as it slows the heart rate, and has also a mild effect against anxiety, especially the non-selective ones, they prevent the heart from racing).
I think most of us who post about heart rhythm problems have sensitive nervous systems and are exceptionally aware of the random ‘noises’ our bodies make. Anxiety makes the situation worse, since it results in basically too much adrenaline (the hormone of fear) floating around, and adrenaline increases the heart rate.
You see the paradoxical problem here for those who get really anxious about what their hearts are doing?
When you are asleep and therefore not conscious of your heart, you would probably be surprised to find out that it’s ticking along at a nice, normal, healthy rate. Really, it would be doing that. Your heart, working seamlessly with your autonomic nervous system, takes care of that stuff all by itself.
Understanding and accepting this next fact is the key: In a young, healthy heart—as yours has been repeatedly shown to be—you simply do not have to worry about the thing galloping away with itself, wearing out and killing you, or being starved for oxygen as happens in a heart attack. That organ will absolutely take care of itself.
Now, the trick is to help you believe that, but out-of-control emotions will make it impossible.
Your posts indicate a terrified obsession with your heart. This kind of thing happens in anxiety states—and it does not respond well to education alone; that is, your conscious brain may understand that you are in no danger from a runaway ticker, but your deeper, more primitive brain centers won’t buy it.
I really believe that you should switch the focus of your therapy to treatment of your anxiety. Judging from your posts, that is by far the greatest problem--not depression.
After we’ve been in a difficult emotional state for a long time, it tends to take on a life of its own, and for you, this has been going on long enough that I doubt it can be treated with ordinary talk therapy such as you seem to be paying for now. My own experience is that psychiatrists are vastly better with anxiety centered on bodily symptoms, simply because, being MDs, they are educated in medical issues.
Why not short-circuit your agony by making an appointment with a good shrink? It worked wonders for me.
You see the paradoxical problem here for those who get really anxious about what their hearts are doing?
When you are asleep and therefore not conscious of your heart, you would probably be surprised to find out that it’s ticking along at a nice, normal, healthy rate. Really, it would be doing that. Your heart, working seamlessly with your autonomic nervous system, takes care of that stuff all by itself.
Understanding and accepting this next fact is the key: In a young, healthy heart—as yours has been repeatedly shown to be—you simply do not have to worry about the thing galloping away with itself, wearing out and killing you, or being starved for oxygen as happens in a heart attack. That organ will absolutely take care of itself.
Now, the trick is to help you believe that, but out-of-control emotions will make it impossible.
Your posts indicate a terrified obsession with your heart. This kind of thing happens in anxiety states—and it does not respond well to education alone; that is, your conscious brain may understand that you are in no danger from a runaway ticker, but your deeper, more primitive brain centers won’t buy it.
I really believe that you should switch the focus of your therapy to treatment of your anxiety. Judging from your posts, that is by far the greatest problem--not depression.
After we’ve been in a difficult emotional state for a long time, it tends to take on a life of its own, and for you, this has been going on long enough that I doubt it can be treated with ordinary talk therapy such as you seem to be paying for now. My own experience is that psychiatrists are vastly better with anxiety centered on bodily symptoms, simply because, being MDs, they are educated in medical issues.
Why not short-circuit your agony by making an appointment with a good shrink? It worked wonders for me.
Ha ha, yeah, I think I was almost better off before that doctor's appointment, mentally at least! In answer to your question, I have been seeing a therapist for some time, but not specifically about anxiety. She's been helping me with some other issues, most notably the depression that has been bothering me for some time. I know that anxiety and depression are very closely related, and ny hope was that if I started to feel more cheerful, I would also start to feel less anxious. My depression makes my anxiety worse, but sometimes even on days when I feel happier, I am still prone to panic. I see your point that I need to deal with my anxiety rather than worrying about my heart rate, but I just don't see how I can't worry about my heart rate, indeed how anyone can't. If a high heart rate can kill you or at least cause heart attack, and there are all sorts of ways that a heart rate can be raised, then how do people live without thinking about their hearts? It sounds so weird, but I feel that the heart should be constantly monitored!
itdood said it well. Have you ever seen a specialist about your anxiety? Believe me, when you find the right therapist for this, your worries about your heart will assume a much smaller place in your life, allowing you to enjoy the things you should be enjoying right now.
With your anxiety disorder you were probably better off not hearing that!
I think your doc's point is that you need to get the anxiety under control.
You are focusing in on the symptoms. This is distracting and a waste of energy. The best course of action here is to fix the ROOT-CAUSE, which is the anxiety.
I think your doc's point is that you need to get the anxiety under control.
You are focusing in on the symptoms. This is distracting and a waste of energy. The best course of action here is to fix the ROOT-CAUSE, which is the anxiety.
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