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Anxiety Disorder and Cardiac Symptoms

I've been DX'd with panic disorder and general anxiety disorder, with a chronic fear of cardic disease, making me cardio-phobic.
With therapy and Klonopin, my panic attacks are under control, however, my chronc anxiety and hypervigilince of heart diesease remains, even though my cardiologist says my heart is fine.
I'm also on Toprol and a diuretic for mild HBP, again, caused by my anxious state.
My question is:As every exam and test points to a healthy heart, how in the world does my mind cause me physical symptoms like chest pain and pressure, arm and shoulder pain, along with heart flutters now and then?  Can a chronic phobic condition actually produce these physical symptoms?
p.s.: I'm NOT hypocondric, as the only real concern i have is heart disease, not any and all diseases of the body.
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239757 tn?1213809582
MEDICAL PROFESSIONAL
jerry,

At some point you will have to believe your cardiologist. Sometimes phobias go beyond even medical comforting, if this is the case it may be helpful to seek comfort through others support(as in this forum) or through professional counseling. If your cardiologist feels this is non cardiac, ask him/her or your family physician for a referral for other counseling.

Yes, it is common for these symptoms even with anxiety. Common methods of establishing cause include stress testing and angiography. If you've had a workup and risk stratification of your symptoms, pursue other causes.

good luck
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Avatar universal
I aam a 35-year-old male who has had the same for the past 3 years.  Everything that you wrote about, I felt.  What made it worse for me is that I was adopted at birth, which was never an issue, until I was in the ER and they asked me "any family history of heart disease?"  I did not, and do not know.  All tests shoswed nothing, so I went to another cardiologist.  And another.  Took stress tests, (1 nuclear), EKG's, holter monitors, event recorders, chest X-rays, and I was enver a hypochondriac.  1 cardiologist sat me down, and told me, "As a father of 3 young children, you have become 'heart aware', meaning any pain your body has in that area, be it a muscle pull in chest area or pang of anxiety, you are fearful of."  But all agreed I was doing the right thing in having it checked out, I just have to stop from letting it take over my life.
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Avatar universal
You are worried about your heart even though there is nothing wrong with you because all we hear about nowadays is heart disease/heart problems. You cannot go for even one day and not read an article in a newspaper or magazine that does not mention heart disease. Everyone is more aware and more scared about the number one killer because its pounded into ours minds day in and day out. Personally, I'm sick of it. Yes, we should be aware of how to keep our heart healthy, but otherwise young and healthy people are getting paranoid for no reason. I worry about my heart the same as you do sometimes. It seems as though every pain in the body is related to the heart. I've heard of people getting a slight pain in their finger and later found that they had a blocked heart vessel. Amazing! The heart is a very simple, but complex organ with leads itself to many problems. Again, that is why heart disease is the number one killer. Hundreds of years from now the human body will evolve from is design mistakes and there will be no more illnesses such as heart disease. Besides coronary artery disease, we have slow heart rates, fast heart rates, PVC's PAC,s, valve problems, enlarged hearts...just no mention a few. Now you understand what I mean.
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Avatar universal
This is my first day on this forum, but I had to respond to your post.  I am 33 years old (male) and have had chest pains on and off for the last 1 1/2 years.  I have been to the ER 6 or 7 times and my family physician(s) countless times.  I have had an angiogram, to echo's and countless blood tests and EKG's.  Also had an upper GI as well.  Still have the pains from time to time.  

However, now that I have had all of the tests completed I can say that my BP doesn't shoot off the scale every time I have the chest pains like it used to.  The 1st time I went to the ER my BP was very high 195/110, but I believe that we panic induced.  My doctor just told me to look up the vagas nerve on the internet and see what I can find...  Have any of you ever heard of this causing chest pains?

BTW, I tried anti-anxiety meds (paxil) and that did not help me, but that doesn't mean it won't help you.

I only share my story with you because I found it slightly comforting to know that I am not the only one who has had this strange pain and be told by all that my heart is fine.

Jesus Christ is the Only Answer,

Tony
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Avatar universal
hi i am new to this forum. i am a 27 yr old female and i was just told i had minor pac's. I just got married and the cardiologist told me it was from stress. i dont think so because they happen when i am calm. i was placed on a holter monitor and that is when i was told he saw some minor pac"s.  are they dangerous?  They are still happening a they really freak me out.  this is all i could think about and it is taking away the joy i should be feeling now!  i also had several ekgs and a stress test as well as an echo. and everything came out fine. Can a pac harm you because the blood is not pumping the right way?  im scared and now obsessing over my heart HELP!!!
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Avatar universal
I'm new to the forum and wanted to take the time to thank you all for sharing your experiences because they help me deal with mine. I also have been obsessing abit about my heart as of late. I'm 33, and have had occasional fluttering in my heart since I was @ 18. It freaked me out then and still does today although I've dealt with it better until lately. I feel like I'm getting "sharp" pains every once in a while more on the left side (arm, chest) than right and coupled with the occasional flutter, it really worries me. I feel fine and still exercise hard as ever. But at nite I think about it and I might feel a little flutter which of course I then start to "freak" and it occurs more frequently. The smallest little pain in my arm or finger or chest I attribute to a heart problem. I've set up a visit with a cardiologist next week to get this sorted out once and for all. By the way alcohol I find, triggers some of the fluttering. Just wanted to share that with you all...
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Avatar universal
hi,
i'm a 30 y/o f, my main problem is a racing heartbeat, but i occasionally get "skipped beats," which is what i call pacs of pvcs, cause it feels like my heart thumps real hard against my chest, but i was always under the impression that they tend to occur more often at rest or while relaxed.  if u have a structurally sound heart (which from your echo, im assuming u do) I dont think they're considered dangerous, just annoying (and very frightening, in my opinion).  Two days after giving having my last baby, I had them nonstop for a whole day, which was really scary and naturally i ran to the er. they said they were "benign heart palpitations.  to this day, i dont know what they meant by that.  I know how u feel though.  Im aware of every single heartbeat i swear, and it's driving me crazy.  its impossible for me to get a post on this forum, so i usually ask hankstar anything i want to know.  he's very informative and has helped me on this forum.  he especially knows about pvcs and pacs, if u want to write a post to him.  he is on this forum a lot.
Regards,
Pan
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Avatar universal
To Everyone:

Well, at least I am not alone with my problem, as evident by the posts.

But, man, what a horrible way to live.
I'm on Klonopin for my panic, and that drug certinly does help in stoppiing panic attacks, but, needless to say, it does nothing in the way of catastrophic thinking, and I worry 24/7 about heart disease.

The one poster hit the il on the head......yes, there is so, so much news reports every day about heart-related issues....eat this, don't eat this, etc., etc.,etc.

I've become so obsessed, got many tests over the years, but still am not satisfied......you know why?....because the truth is that one can go from a 0% blockage to a very significant 100 % blockage of their coronary arteries in a very short time.....I hope I can someday overcome my phobia, but for now, its constant worry, chest pain, tachacardia, left arm pain, shoulder pain, fear to even exert myself, even daydreams of going thru an emergency cath or by-pass.....how sad is that, folks?
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Avatar universal
o you have an excellent handle on the ature of your anxiety and that is an excellent start;

o 'life' is a inpermenant situation and full of many risks and your risk from driving a car to work likely far exceeds your risk of AMI unless you have multi-factored risk profile for CAD/AMI;

what is you family history ?

o there is a lot of evidence that Cognitive -based Therapies work well in conjunction with medication for Panic syndromes;

o reasonable levels of heart-friendly diet:

such as a modified vegetarian diet with fish and chicken can improve the lipid (including arthrogenic subfractions) profiles...more whole foods-veggies and fruits, less processed foods (loaded with refined flours, sugars, trans fats), eating more frequent smaller meals, substuting monosaturated for saturated fats  etc

some American diets are positively toxic...;

o (almost any) _regular_ exercise:

has multifaceted benefits on mood, whole body habitus well being, stress relief, endothelial function, lipid profile, etc etc...Just Do It...everyday...walk the stairs etc...;

o meditation/ 'mindfullness' training/ yoga :

has been shown in a number of studies that have marked effects on health, refractory pain syndromes, PTSD etc ...lookup the books by Jon Kabat-Zinn (see Amazon) who initiated a well respected Pain Management Clinic in Worcester Mass that has seen dramatic results over the years and been replicated across the country;

P.S. if you want I'll give you my email and we can continue this discussion at greater detail off the board...over time...;

o recycle the blind fear and huge energy you're devoting to it into pro-active programs to mitigate the life risks including CAD using the best of current knowledge which is all anyone can do....;

my uncle was a very accomplished Mayon Clinic trained pediatric cardiac surgeon and took meticulous care of himself...lived 20 years longer than his two brothers hwo died from cardiac situations...then died after 4 years of Alzheimers where his marvelous mind melted...so it goes...on the other hand my 90 y.o. Mom smokes and eats bacon sandwiches and a pint of full fat ice cream at a sitting...she still rakes leaves, cuts grass and shovels snow...life ain't fair...get over it..Live....;

be well my friend...;

//
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Avatar universal
Anything related to your heart can be very disconcerting.  Anxiety only creates more problems.  There is peace in knowing your anxiety symptoms are shared by others and you are not going crazy.  My father has been almost incapacitated by his fear of cancer and heart attack.  Head to you local library/bookstore or even a site like bookfinder.com and find some books to help you.  I would recommend the following:

Claire Weekes, Peace From Nervous Suffering (she tends to focus on agoraphopia but the anxiety symptoms she highlights apply to anyone)

Dale Carnegie, How To Stop Worrying and Start Living (written over 50 years ago, it still applies today...gave this book to my dad and it really seemed to calm him)

Lucinda Bassett, From Panic to Power (great techniques to calm you)

Eckhart Tolle, The Power of Now (my personal favorite)

Good luck to you!
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Avatar universal
Hi Jerry-
I have an idea that might help. It's given me more confidence anyways. I'm only suggesting it because your cardiologist said your heart is fine. You wrote of your concern about exerting yourself. Well, my thinking was somewhat similar, but I still continue to exercise. Do you know that it actually calms me and gives me more confidence? I usually ride the bike for 20-25 minutes 2x's a week, enough to get my HR up. Why don't you try some very light cadio work of some kind for 5-10 minutes and maybe build a little every other day. I really do feel that this will help your confidence level which will in turn calm your mind, not to mention stimulate those endorphines (s.p.). This helps me deal with it more realistically. Also a better diet of fruits and vegetables is helping me more. I'm trying to get rid of the dairy. Take care Jerry.
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Avatar universal
You all have my sympathy...or would that be empathy? I have suffered from anxiety most my life, not coincidentally brought on about the same time I became aware of my heart "irregularities"...extra beats, occasional PSVT. I have tried drugs and some counseling...but it is one long battle. I do exercise almost every day, but still fear heart problems even thought I have had every test in the book, all normal, and have a good family history. I'm 47 now, and am really upset about all the time I have wasted and places I have not gone or didn't enjoy because of my obsession with my heart. It is like OCD. No matter how much I try to stay positive, the negative thoughts keep coming back. It's a curse! I wish good luck to anyone suffering this fate...There has been some good advice...keep the suggestions coming...maybe there's something out there that will cure all of us at last!
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Avatar universal
i just wanted to say thank you! It is very comforting to know someone understands.  I guess i have to live with these annoying flutters but it is so hard to forget about them. The worst part is even if you dont get a flutter one day you ruin your day worrying if you are going to get another!!!!!!! Im actually going to join yoga to try to stop being so anxious and maybe hopefully they will go away FOrEVER!
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Avatar universal
Hi,

I've heard about the yoga thing for anxiety. Heard good things. I've thought about doing it recently. Maybe it will help. I'll try anything so long as it's not drug related!  
Let us know how it's doing for you and I'll do the same. Good Luck to you :)

Tammy
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Avatar universal
IMO you can start to think about the anxiety link a little too much, up to the point where the two get jumbled together to mean the same thing - ie I'm feeling anxious so Id better calm down or my heart will start playing up (and it generally will..) or the other side of it, My hearts a bit irritated, I must be anxious...... both become a self maintaining cycle.

My understanding is that anxiety serves to increase your sensitivity or self awareness that means that you're more likely to notice things.  Don't make the mistake of thinking that to control your anxiety will be to get rid of the palpitations.  That kind of thinking will only serve to set you up for a fall.  Your aim should be to accept them and learn to live WITH them.  When you can do that you'll be on you way to feeling better.  Eventually they won't matter any more, your sensititity will lessen and you MAY not notice them anymore (and even if you do - it doesn't matter!).

So dont make the mistake of thinking that you get cardiac symptoms because of your anxiety problem.  The reality is that you get palpitations just as most of the population does, anxiety just make you sit and take notice.

Regards
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Avatar universal
I'M RIGHT THERE WTIH YOU.I'VE HAD THE SAME PROBLEM YOU TALK ABOUT
GOING ON 4 YEARS.IT'S HURTING MY MARRIAGE,AND MAKES LIFE A HARD ROAD EVERYDAY.I WORRY ABOUT MY HEART 24/7 I'M 41 YEAR OLD MALE
NEVER HAD MANY HEALTH PROBLEMS. HAD HIGH BLOOD PREASURE AS A TEEN
BUT HAVE ALWAYS KEEP IT UNDER CONTROL.TRIED LOTS OF BP MEDS SOME HAVE BAD SIDE EFFECTS.BUT FOR WHAT EVER REASON I CAN'T STOP WORRING ABOUT MY HEART.HAD ALL THE TEST (stress test,strsee echo,
blood work,so many ekg's hair jumps off my chest when i go to the doctor.)I AM OVERWEIGHT.AND DO HAVE ANXIETY, DO HAVE SO PVC'S
THE DOCTOR SAYS DON'T WORRY ABOUT THEM YOU KNOW HE NEVER HAD THEM
THIS FORUM REALLY HELPS LET US KNOW WE ARE NOT ALONE.


THANKS!
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Avatar universal
This is definatly a raunchy road we are on isn't it? Some days are better than others, even so, we are obsessed with our hearts aren't we? So much so that we don't realize the extent of the obsession to the point that it begins to burden our relationships. You said you have gone through this for four years? Mine has just been going on for about 6 mths or so, and I am beginning to see the frustration it is causing my family. This is psychologically burdensome as well. what we "feel" the docs say is no biggie ... hmmm. Not so easy for us sufferers to accept. I haven't been in this forum for too long, maybe a month, but it sure does help out alot. I feel a bond here with people I've never met. Even if I don't post a comment/question, reading the same or similar symptoms, or even worse that mine, I feel I'm not alone, as I sometimes, most of the time, do here at home. It is so great that we have each other!! Don't know if you've read much of Hankstar's posts ... but I have read just about everyone, and reading what he posts is great comfort to me. He's very knowledgable, comforting and optomistic. I see alot of people receive the same solice as I do from any posts regarding him.

Hank ... if you see this post ... thank you from the bottom of my heart :)

hammerhead ... you are not alone buddy :)
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Avatar universal
Hank,

Wow, labled a cardiac cripple .... and to think that when I heard my cardiologist simply saying I was "symptomatic" I became consumed with fear. I wondered, sypmtomatic for what? heart failure?

On a more personal note ... you said you never let it interfere with your romantic life. Hope I'm not being to personal or offensive, but I guess I do let it interfere in our romantic life. We've been married for 8 yrs. Have 5 and 7 yr old girls and a 13 yr old boy. I'm terrified that if I get (trying to choose the most appropriate words here) too worked up, I'll have a heart attack right then and there. Therefore, that part of our marriage has been strained for months now. Did you not ever feel like that? Am I getting to obsessed with this whole thing?

Thanks Hank!
Tammy
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Avatar universal
Hi Hank,

Do you not ever have panic/anxiety attacks? And if so, how do you cope with them? Even more so, how does your wife cope with  them? My husband was wonderful at first, but I can tell he's getting fed up with it all. He does his best to be supportive and all, but I can see the frustration. It just seems he'll soon tire of it. Of course, as an outside observer, he can't possibly know what I'm feeling like. Hmmmmmmmmm ... maybe it is the sexual deprivation getting to him. Ok ... maybe I'll have to take a xanax and give it a shot, however i'll be there thinking ... ok heart rate going up ... Hank said this and this .... Oh my. Never thought sex would be so difficult!

You have a great Christams Holiday Mr. Hank, and thank you so very much for reading and responding to my incessant chatter :)

Tammy
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Avatar universal
Hi Tammy,

You go girl!
Buy something nice and seduce your husband!
My, won't he be suprised.
No Xanax; you'll fall asleep during.. haha!
I'll bet your anxiety will subside overall too.
You feel more relaxed.
Won't that be something, eh?
You'll be just fine..
-
And the beat goes on...   - lovely days to you and yours.

*Ianna*
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Avatar universal
Man! I sure tried to talk myself into it last night. Didn't work. Got myself a good anxiety attack though! To think, I used to be one wild cat in the sack ... now look at me. I'm pathetic!! Could ya cyber slap me or something here? Why do I get so freaked out at night? EVERYnight? Maybe I've got some night-time brain tumor? Sheesh! Ya know, Im pretty good during the day, come 8pm ... Im all wigged out till I pass out for the night. What's my problem????

Deprived in every form of the word,

Tammy
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Avatar universal
I could not believe when i read this question..These symptoms fit me to the letter. I feel like this is running my life and all I think about is when I am going to have my next panic attack. I take medicine as well Effexor,Xanax and a lopressor for the palps. I just separated from my husband the beginning of this month and things have been hard.I worry constantly that I am going to have a heart attack its like it consumes me.My cardiologist is such a wonderful man.He understands when I call in a panic. I do see a therapist as well. They blame it on my past because I was severly abused as a child and I never dealt with it. I dont understand why it would affect me now 10 years later. My cardiologist keeps reassuring me that my heart is fine. When he told me I had 11 irregular beats out of 117,000 that really scared me he said they were PVC or PAC I am not sure what they are. Sorry about babbling but I feel a little better knowing I am not the only one suffering from this.
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Avatar universal
I too was abused (sexually) when I was younger. I was 12 at the time. I never told a soul until just a few years ago. It was an uncle who did it to me. Then I married at 17, had a child, marriage lasted about 2 yrs, my son and I were severly abused by this man, to the point where he tried to strangle my son, and beat the living **** outta me. I've found I'm not too trusting when it comes to men, but I figured I had dealt with it, but it was recently mentioned to me by a close friend who served in the vietnam war who is going through post traumatic stress disorder all these years after that maybe I too am suffering from the same thing. I don't see how though, I never think about any of that stuff. I don't harbor any resentment (atleast to my waking knowledge) toward the uncle who violated me in such a horrible way. I see him all the time. I don't feel as if I want to rip his throat out, but I do on very rare occasion get lost in a stare at his fingers sometimes and can remember as if it were happening all over again. But when I snap back into reality, I just thank God I don't have to suffer any of that ever again. As for the ex-husband, I don't really think about that at all. I have a wonderful husband now and my son has a wonderful father (as you might have guessed the birth father is NEVER to be in his life again). So I just can't fathom my present problems having any relation to these things that happened so many years ago. But your therapist says it is possible huh? That what happened to you way back when is the root of the physical symptoms you are dealing with today? So what they are telling you is that you have PTSD?

And you thought you were rambling ........ :)

Tammy
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Avatar universal
Boy...did you two suffer..
No doubt in my mind that the main reason of your anxiety (both) are these horrible events in the past.
All is still there in your sub-conscious, you know.
It is not gone because you say you don't think about it anymore.
I even suspect you once in a while dream about it, perhaps in another form.
And you Tammy, still sometimes facing this(silly, silly)man..
-
I think a good therapist, and talk, talk, talk about it.
My guess is that you'll then get very scared and angry and cry your heart out, -but this way the little girl inside you might understand, forgive and find peace.

Lots of love to the both of you. - *Ianna* -
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