Can sinus tachycardia (high resting heart rate) REALLY be caused by anxiety?

[fearfactor]

Hi, I have been going thru severe health-related anxiety for the past 2 months.  It is primarily centered around my heart.  I am also feeling very depressed about this, as well as problems with my husband and general unhappiness with what I am doing in life right now.  I've been to the ER twice, to my GP numerous times, to a cardiologist once and have had all the tests for heart problems run.  The only thing they can find is sinus tachycardia, which they say is merely a fast heart rate.  My resting heart rate is normally around 90, but can go up to 102 or so.  Sometimes I wake up in the middle of the night with it VERY fast (up to 130) and I'm trembling.  Also, it usually gets very fast when I stand up from bed in the morning and takes a while to calm down (even with .25 or .5 of Xanax).  My doctor thinks I am nuts - she keeps telling me this is all anxiety-related.  But, I can't believe that just anxiety could cause your heart to have such a high rate.  Is this true?  I'm being tested for an adrenal tumor I found on the internet upon my insistence and after that I'm just going to give up on trying to find something wrong with my heart.  I'm afraid I will then try to find neurological or pulmonary or some other kind of problems to explain my symptoms.  I do have panic attacks from time to time, but mostly I just have a general sense of unease and worry ALL day long every day.  I can't enjoy life any more.  I'm taking beta blockers to slow the heart and it works to stop the huge jumps in rate but doesn't generally lower the resting rate much.  So, my main questions are:  1.  Can I believe my doctor that this is due to anxiety or should I continue looking for some other cause?  I obsessively search the internet to find some cause for tachycardia all the time, even missing school to sit and do it for hours.  2.  If you have experience with treatment with beta blockers for anxiety-related high heart rate, can you tell me which beta blockers work best?  I'm on Toprol xl 25 mg a day.  It makes me even more tired and depressed and doesn't help much with resting heart rate.  Might Inderal be better?  I've heard some good things about it.  

I am in therapy but I'm a person that is very skeptical and it's hard to convince me of things.  I'm scared this is going to keep spiraling until I'm institutionalized.  

Thank you,
Stacy

[Roger Gould, M.D.]

Stacy, the most important answer is yes, anxiety can cause panic and rapid heart rate without any other cause....Being in therapy is the best for you, but in addition to beta blockers, you might ask your doctor for longer lasting anti-anxiety medication like klonopin.   Both of the beta blockers you mentioned work equally well.

[Paule]

I had to chuckle at your heart rates...Mine go from 70 to 180 to over 200 with sinus tach.  Going from 90 to 102 will happen climbing a set of stairs, even going to 120.  

This is nothing. Start working out more with your docs okay and do some yoga.  Your heart rates will go way down.

[Jackie41]

Stacey:
I too suffer from Panic Disorder and sinus Tach.  I was on Tenormin generic name atenolol for 10 years.  It was working fine and then one day just stopped working.  I have tried Diltiazem (which didn't help much at all), Toprol (which actually made it worse), Zebeta (which didn't help either), now I am on Altace which doesn't seem to be helping either.  I have read several reports on the internet that sinus tach and panic disorder are connected.  I don't think there has been enough research on this subject.  It sounds as though you have GAD (generalized anxiety disorder).  I would make sure you find and excellent therapist who you feel comfortable with, and although every cardiologist I've talked to says that sinus tach is not life threatening; it sure as heck is scary and extremely uncomfortable.  In my case disabling at times.  If your current Cardiologist does not take your fears and concerns seriously, then you need to find another.  I have had sinus tach for over 20 years, and still haven't found a cardiologist who can help me with the symptoms; although my current one is trying.  Best of luck to you!!!

[SAPHIRE435]

I understand how you feel! I went through this for years! I just wanted to let you know that anxiety can cause so many symptoms and rapid heart rate is on the top of the list. I finally agreed to try Paxil back in 1999 after a trip to the hospital with a heartrate of 214. It had been up for hours. For the last five years I have been on Paxil and Atenolol with WONDERFUL results. I recently switched to Zebeta due to pregnancy. The paxil really made a huge difference.
I am also a social worker and have worked with many clients with anxiety and panic and it's amazing how many people go through the same things. I went through counseling with cognitive behavioral therapy for about two months, which also helped. Feel free to email me if you would like to talk. My email is kristi.***@****
Good luck to you!

[Wiz_NY]

My heart rate ranges between 110 and 120 at rest without a large dose of Klonopin.

The DR I see told me that I might have to remain on Klonapin - for good; only timw will tell. He first tried xanax with me - but that XR form put me to sleep.

For some of us, apparently, amxiety can be or appears to be - permament.

Lexapro also may help - if anxiety related.

Try the Klonopin generic in .25 tablets twice a day; see if it helps; also, 10 mg of Lexapro might help. It works for me - but all people are different; as are all Dr's. It takes a while to find a good one.

Also, teaching hospitals might be helpful - if one is located near you?

Search the web for trials?

Verify what any mD tells you; some are wrong; I've encountered at least 5 who were less than excellent.

[Kitrina]

Hello,

I was diagnosed as having MVP at age 15.  Through out the years I have had to be on beta blockers off and on depending on my physical activity and my stress level.  Three years ago I started having Tachycardia in the middle of the night.  I would wake up out of a sound sleep with a heart rate of 180bpm.  This was startling and very scary.  I couldn't breathe and moving would only send my rate higher and higher.  I now take Beta Blockers every night (as late as I can) so I can get some sleep.  This medication does not work all the time but at least when I wake up my rate is not as high as 180bpm.  This has turned my world upside down.  I do not get the sleep I need and after a rough night I am absolutley tired out the next day.  I can no longer work and have a hard time taking care of my family at times.  My Doctor just seems to think it is my MVP and keeps telling me to just up my medication.  If I take too much medication I am dizzy, groggy, and depressed.  If I dont take enough Meds I have a racing heart at night. I also seem to wake up at the same time everynight so I try to trick my body by going to sleep at different times.  I am just just floored over this and my Doctor can't seem to tell me why I am getting these attacks at night.  I wonder how much can a heart actually take of constant pumping and racing before it starts to give out.  I turned 40 this year and wonder if hormones play a part in this.  Is there and other night time suffers out there with suggestions or adivse as to what could be causing this?

[Kitrina]

Hello,

I was diagnosed as having MVP at age 15.  Through out the years I have had to be on beta blockers off and on depending on my physical activity and my stress level.  Three years ago I started having Tachycardia in the middle of the night.  I would wake up out of a sound sleep with a heart rate of 180bpm.  This was startling and very scary.  I couldn't breathe and moving would only send my rate higher and higher.  I now take Beta Blockers every night (as late as I can) so I can get some sleep.  This medication does not work all the time but at least when I wake up my rate is not as high as 180bpm.  This has turned my world upside down.  I do not get the sleep I need and after a rough night I am absolutley tired out the next day.  I can no longer work and have a hard time taking care of my family at times.  My Doctor just seems to think it is my MVP and keeps telling me to just up my medication.  If I take too much medication I am dizzy, groggy, and depressed.  If I dont take enough Meds I have a racing heart at night. I also seem to wake up at the same time everynight so I try to trick my body by going to sleep at different times.  I am just just floored over this and my Doctor can't seem to tell me why I am getting these attacks at night.  I wonder how much can a heart actually take of constant pumping and racing before it starts to give out.  I turned 40 this year and wonder if hormones play a part in this.  Is there and other night time suffers out there with suggestions or adivse as to what could be causing this?

[[e-mail]]

i have had this since i was 17 and i am now 52. i tired beta blockers and i felt like i couldnt breathe. it helps to waer a halter monitor at night however mine didnt race onthe nights i wore it--go figure.  My condition was thougth to be panac attacks until i told the doctor the panac was cvoming from the attack. After having it. Not before. So after eccocardiagrams we determined i had MVP and supra -ventricular tachacardia(sorry-spelling??). I have learned over the yrs to wake up drink water clam down and bare down like you are having a bowel movement or rub jugglular vein in neck and it breaks the heart spasm.  this sometimes helps.  another cardio told me it is definately hormone related and as we get older it should calm down a bit esp after menapause and there isnt eh ups and downs of the the hormones.  Mine seems to be worse after ovulation and before my period.  When i worked out three times a week and walked two days aweek and lost 30 lbs -- I stopped having these spasms.  I dont know why.  As soon as  istopped and gained weight back I am having them again.  My boyfriend is trying to have tests to determine if he can have a heart transplant-- I am considering taking lexipro but onthe warning one of the side effects is a racing pulse-- anyone know? I am worrying 24-7 about his health which makes mine pale incomparison. Good luck girls--try the two methods i menoned when it is in spasm this taught to me by a cadiologist yrs ago. raechel

[slarew]

wow! what you described is EXACTLY what happens to me now. I do have Panic Disorder and was doing therapy and only 5 mg of Lexapro, but then I started to get a cold, and then I started to really panic. Later that day, I was walking up a steep hill and had a palpatation that stopped me dead in my tracks, and wouldn't you know? The heart rate shot up and I felt the panic come on full blown. I tried to breathe as I continued to walk to class and tell myself, hey you're still walking, you're fine. But then I sat down in lecture, and it felt like my heart was jumping out of my chest! I checked it and it was 134 and tried to breathe some more and give it time, checked it again and got 128, then I started to really panic and I went to the ER and my heart rate got up to 160, but they were saying it was just sinus tachycardia. I just got out of the hospital today after NUMEROUS tests and they haven't found anything wrong with me, but I am going to see my psychiatrist again and get into a cardiologist just to make sure it's just anxiety.

Tonight though I was doing fine until I took a shower and started to think about my anxiety and focusing on my heart, and then I started to get some chest discomfort and took my heart rate and it was around 130. I laid down and did the breathing technique I learned from my therapist for a couple of minutes, and when I retook it, it was down to around 90.

I just wanted to say that yes, apparently anxiety can cause a lot of this. I didn't believe it at first either until I read the message board. I just wanted to say thank you to all of you guys because it really calmed me down to realize this is something I can control and it is not fatal.

thank you!