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Avatar universal

Opinions.. Why do you think palpitations are so scary to patients?



Ive noticed alot, and even the own forum doctors have mentioned, how patients presenting with benign palpitations are so afraid they are dying, and yet the seriously ill patients with prior MI's or are at very high risk, dont worry about this at all.. Does any one have any personal insight or opinion as to why this may be? Its always made me wonder..
31 Responses
Avatar universal
Lots of it is because they do not trust their doctors/cardiologists.  On the back of their mind there is always the "what if" they (doctors/cardiologists)might have missed something, they made a mistake etc. They go on message boards and believe when somebody says "your next exercise might be your last" as I was told on this very board 3 yrs ago when I mentioned my PVC's during exercise.  I, myself only believe what a Cardiologist tells me, but not everybody is like me, some people take these posts/messages veyu seriously. Some people cannot afford health insurance, and come on message boards because they are scared and are looking for answers instead of going to a free Clinic or ER at a Teaching Hospital where they get billed accordingly or not billed at all.  

Why do people who had an MI or a serious heart problem are less scared?  Because most of them if not all of them have received and are receiving treatment.  There is no "what if", they know they had a heart attack, the Cardiologists told them exactly what is going on and what the future has got in store for them i.e. with heart failure for example, the Cardiologists lay it on the line that after a heart attack you need to do certain exercises and in most people life style changes if you want to live long enough to see your kids/grandkids graduate.  

There are still people after a heart attack who are also scared, not trusting 100% what their Cardiologists tell them afraid of another heart attack at any time even though the Cardiologist tell them there is a slim chance.  I know of one case where the person quit his job out of fear he'd have another heart attack at work, he is at home afraid to go anywhere, his wife goes to work to support them.

Last but not least Professionals in the Medical field need to understand about anxiety.  Just because they never experienced PVC's or extreme anxiety it doesn't help the patient when a Medical Professional says stuff like "exactly what are you afraid of?" I never heard of that.  "So your heart skips, just let it skip".  Therapists/Psychologists to quickly to prescribe pills instead of really talking to the patient for the one hour you pay them for, and not sitting there totally quiet while you spill your guts out, all along you know they are thinking of something else.  It should not take a book to help a patient as it did for me.

Unless the Medical Professionals take people with a "heart phobia" seriously instead of asking themselves "we don't understand why people with benign PVC's are so afraid while people with serious heart attacks are not"  This of course is not true.  I know people who are so afraid of another heart attack they became invalids.  One of them even managed to get disability out of fear any job would damage his heart.  The docs didn't want to agree for the disability at first but after many months he got his way.

And maybe if doctors would not hurry out patients out of the door after 5 minutes when the Insurance pays them for 45 minutes, maybe some patients would have more trust in their doctors.

And maybe if they would experience these PVC's for themselves, especially when every other beat skips for weeks, maybe then they would understand better and not ask stupid questions.
97628 tn?1204465633
My father was a young person with diagnosed CAD and he simply would not comply with doctor's warnings about being cautious. His primary food source was the 7-11. Funnily enough, this is a common characteristic of people who are actually sick. It is understandable because emotionally healthy people don't want to be disabled and don't like living as if they are.

Often with emotional/anxiety issues the person is all too willing to give up on life, retire to bed, avoid exercise, stay cloistered in the house for fear of dying in public etc.

My guess is that it is quite normal to, initially, respond to heart palpitations with some concern, even for the concern to persist for a little while and to go through "stages" before realizing that everyone gets these beats, most healthy hearts just do that,one is still here and clearly the palps are not serious.  

That said, some people are prone to fear, depression or obsessive thoughts. I also believe that many people have certain stressors that they do not wish to acknowledge as such. Burying complicated feelings may also have something to do with it. I will wager there are many personality traits in common, many of them (like sensitivity) quite good traits in the right context.

Now, clearly, the brain monitors everything, so it can easily be implicated in all sorts of problems people experience, not to mention genetics, but sometimes people would rather be ill than stressed. This way they are "proven" "right". Like that old joking tombstone inscription: "See? I Told You I Was Sick".

If one has a battery of healthy tests and still insists, it could be that one is "right" (generally about having a non-life threatening condition), but the probability is clearly on the side of anxiety/stress reaction.

This kind of fear cycle is hard to break, and my suspicion is that being on the Internet does not help at all, regardless of what people think. My guess is that the cycle itself needs to be broken. Doctors are even trying Auditory Therapy to break it (interrupting obsessive thoughts).

Avatar universal
Momto3 and the rest of you make great points! Im thinking of doing a research paper on this topic as it fascinates me!  Why would a smoker, whos told smoking is so dangerous for you, or anyone with a particular lfestyle or other health risk (such as anxiety, which will probably hurt you more than palps) , be content to suffer the consequnces of those and still focus on the benign palps... Ide LOVE to be involved in a study on this..An actual physical study of people who have health related anxiety due to palps.. Ide love to see their body's physical reaction to the palp, whats going on inside,.. Inside the brain, the adrenals, everything.. There the med geek in me came out!

Thank you everyone!
21064 tn?1309312333
I completely agree that despite any internal, external,environmental or other factors, each patient should be considered as a whole person in need of answers.

I have a doctor who says that each time a new patient arrives in her office, she considers him/her as a special package (gift) to open.  You can begin by reading the card (chart), untying the ribbons (listening to the patient's symptoms, and learning as much as you can about the contents.  She said that it makes every patient special! What a great way to meet a new doctor -- as if you were a gift, something very, very special!

Avatar universal
My grandma was born in 1886, NOT 1986
21064 tn?1309312333
WOW!!  Interesting question!!  

Along those same lines, why do so many smokers worry about palps when they should be worried about the cigarettes? The doctor looks you in the eye tells you the palps are benign, but that smoking is dangerous to your health...you continue to smoke and worry about the palps.  Hmmmmm

I know others who deal with serious heart disease and other health problems. They don't seem to dwell on the bothersome effects of their afflictions (ie, nausea, palps, SOB, etc). Instead, they accept the diagnosis, follow the suggestions of their doctors, and live their lives as best they can. I think when you are afflicted with a serious illness, you learn to value the smaller things in life, and opt not to dwell on the things that may be beyond your control or those which you have been assured are not relevant to your well-being. You've gotter bigger fish to fry...

On the other hand, in healthy folks, pvcs present us with a physical reminder (the thumps, bumps, flips) that we might not be "normal." Once the doctor assures us that we are fine, we find it "necessary" to dwell on the what if's.  However, had we actually been diagnosed with a serious illness, the palps would become less significant. Imagine you are told you will need a biopsy or a scan b/c they "found something." Suddenly, your benign palps are not so important. When we have nothing else to worry about, maybe we focus on what we "notice."

I've come to accept that there are some things in life I can control, and others I cannot not. I've found doctors that I trust and are willing to offer assurance coupled with a thorough diagnostic workup when it is necessary.

I don't even know if that answers the question, but I tried : )  

Hope you are doing great!
Avatar universal
I agree with you totally - and you too Kit.

It's the FEAR.

When you are actually dx with a condition you know what you have to do.  In the case that Collegegirl has requested.  For a patient who has had MI they are treated accordingly, told what lifestyle changes they have to make - given the meds, have follow up appointments, checked on regularly by the medical field who know what they are dealing with and know how to deal with it.  Same for me when dx with MS I know my limitations, I know to expect etc., and I am dealt by sympathetic neuros who know how do address my relapses as and when they occur.

When I see the cardios about PVC's and they say that they are benign and to get on with my life and that they are all in my head I feel that in their minds they are thinking "oh here we go another one".  It is something that they don't have any answers to.  When questions are put to them like "why do I get thousands a day and sometimes none? Why do I get more lying down?" they just look blank and say "well it's all in your head"

So I think the reason that so many people find them scary is that the heart specialist can find no reason for them, and so they just dismiss them and us in the process  (leaving us to feel that we are going totally around the bend) still trying to find that one tiny little reason that we are having them, never for once believing that to be having thousands of PVC's a day is a normal event, but to the cardios they are!!!

I also agree that the Internet is great source of misinformation too - and that some of these other websites can scare the living daylights out of you.
Avatar universal
Unless a doctor/nurse or any of their relatives are having severe PVC's they do NOT understand.

Let me give you an example.  I've severe white coat hypertension for the last 30 yrs.  I have a phobia.  I tried to get help over the yrs.  Anti anxiety, anti depressants even beta blockers did not help.  When at a doctors's appointment and when having my BP/Beta Blockers etc.  Without meds it went to 255/160 one time.  At home it was 115/75 most of the time. If the tranqualizers/anti deopressant were increased I could not function, wanted to sleep all day, but my anxiety was still there, not as severe, but the BP still shut up over 170.  I took this anti anxiety/anti depressent medicine route for 2 yrs, to no avail.

I seeked professional help.  This is what I came across and got from professionals as in doctors/nurses:  "What exactly are you afraid of??  that the cuff wont deflate??,( I felt totally humiliated) or "all you need to do is take a deep breath" jeah right, believe me I even was in deep breathing exercises/therapy and biofeedback.  20 yrs ago, when I was still younger a male nurse said to me "I bet your BP rises so high when you see a good looking man like me" of course he was joking but it didn't help me any.  Or medical staff after taking my BP were raising their voices "oh my god, look at that BP YOU HAVE TO CALM DOWN", scolding me like I did that on purpose.  Every time before taking my BP I said "don't tell me, the numbers will be high, let the doctor tell me", but every time I got the same reaction, "oh my god" of course the anxiety got even worst, and I ended up rushed to the ER one time when my BP was 255/160 after they scared the hell out of me on top of my already high BP due to anxiety.

I seeked Therapists about this phobia.  One of them made me yell at a chair pretending the chair was my BP, I even went to a Psychiatrist, get ready for this:  I was in and out in 3 minutes max, he said "stay away from hospitals and doctors", and walked out.  I turned him in with letters and brought it to the attention how unprofessional he was and also told my Insurance company and prepared them for the "3 minute bill" which I'm sure he did not mention that he saw me only for 3 minutes.  How can anybody even a young person stay away from doctors and hospitals???????  I was 35 yrs old at the time.

Fast forward to 2005.  I saw a Cardiologist and told him about my white coat hypertension after it was 220/127 when his Technician took it.  The Cardioilogist told me "OH I KNOW EXACTLY WHAT YOU ARE GOING THROUGH MY WIFE HAS THE SAME PHOBIA.  FROM NOW ON TAKE YOUR BP AT HOME AND BRING IN YOUR READINGS TO "EVERY" DOCTOR YOU GO TO".  You see, it took a Cardilogist whose WIFE was in the SAME boat as me to "UNDERSTAND".  

He put me on BP meds, even though I think it was all anxiety/phobia, but I do take the BP meds but he also told me that if a severe panic attack all the BP meds will not help at that moment for people who react very hypertensive during a panic attack.

I get these attacks 95% under control, thanks to books by some Australian Psychiatrist who was interested in people like us and was interested to really help us.
Avatar universal
I can really relate to what you have gone through.  Once they found out that I had FH, I had to go to Boston Children's hospital every month to have my blood drawn and other tests done.  Childhood is such an impressionable time and those things stay with us.  The fear of losing someone you love is very powerful.  I think it's very difficult to unlearn fears that were set in place at a young age.  
Avatar universal
This is very interesting to me.. I really want to see what part of the brain is active immediatly following the palpitation.. I think figuring out exactly what physical reaction is happening and WHY its happening (whether it be triggered memory, predisposition to anxiety or depression) could greatly help patients suffering from obsessive thoughts and anxiety due to the palps.. Imagine if medicine could identify exactly the reactions happening in the brain that are causing patients to obsess on this one thing, how many people could be treated through medication or CBT and be spared so much grief.. Palps would only be the start!

Thanks for everyones input! Ide love to see more if anyone has anything else to add
97628 tn?1204465633
I always had normal BP readings until I went to the doctor and had some (thankfully benign) tissue removed from my mouth. The anesthetic partially failed and I was in terrible pain during the procedure, my blood pressure shot up and after that, my trips to the doc had higher readings. In one docs office the nice nurse would take it, get a normal (120/80) reading and the doctor would barge in say "Let ME do it" and, sure enough, get a (low range 140/90 ish) "high" one. After that I got 140/90 ish in all docs offices for a little while.

When she tried to medicate me, I ignored her and now, just months later, when I go in to the doctor's office my BP is always normal and everyone seems to have forgotten "the crisis" LOL

Side note: When the BP thing was going on I asked for a 24-hr monitor before I would accept meds.  She said she could borrow one from the pharmaceutical company. When I went in for it on the day appointed, they said the pharmaceutical company had stopped providing the amublatory BP monitor. I immediately realized it was no longer provided because the 24-hr readings were probably showing a great deal of white coat HTN and that meant they were losing Rx's for their products :-/

Sherma: The reaction of my BP in that one doctor's office does illustrate your point about the effect of fear on the body. She intimidated me enough to temporarily raise it. Fear and stress over palps could easily cause more palps and make them feel worse.
Avatar universal
Could it be because cigarettes are an addiction?  People know what cigarettes can cause yet they can't stop just like drug users, and unless they get help can't quit.  I know some of them can quit cold turkey but many can't.

My husband tried for many years and always start smoking again.  He smoked 4 packs for 45 yrs.  Four yrs ago he had a lung cancer scare and the Lung Specialist told him if he doesn't quit smoking it will turn into lung cancer.  He had a benigh nodule on his lung.  Even with that lung cancer scare it took one year of pills (Welbutrin) for him to stop smoking, and he tells me several times a week he dreams about wanting a cigarette, smoking a cigarette, two nights ago he dreamed that he bought 4 cartons of Marlboro, and this after over 3 yrs since he quit smoking.

I guess if you have a severe addiction you can't quit, no matter how many warnings, people keep on smoking and worry more about palps unless they get help to kick the smoking habit.  Its a very rough road.  I never smoked but I witnessed my husband what he went through, the urges, the shaking of his hands because he wanted a cigarette so bad.  Nicotine gum did not take the urge away only the Welbutrin but not 100% he still got the shakes.  And working with co-workers who all smoke does not help either.  
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