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Avatar universal

Synus Tachicard WHILE running and other ANXIETY issues

Hello and thanks in advance for any help

My question that I was unable to get answered in my hospital is as follows:

-Sinus Tachycardia is not dangerous and it comes as a result of Anxiety and stress, When you are at rest, ,lets
say at 75 bpm heart rate, it will go up to 130-140 due to anxiety sinus tachycard,,. However it has happened to me running while my heart rate was 160, and when the tachychard hit due to panic attack, it went up to 180...so it stopped runnin, and it took a while to go back to normal.

Is it dangeorus to keep running while having that kind of tachycard? The problem with this is that the heart rate is very high due to exercise intensity and the  anxiety, let's say 180bpm , but the exercise intensity is low, in a normal day without anxiety, that exercise will make heart be  around 160 bpm ...
I believe the heart does not beat the same way if you are at 160 bpm due to exercise than if it is due to anxiety, right? but both of them together?

This is: Heart rate is  increased..but not only for exercise...Are those bpms dangerous? I reach the maximum bpm easily but not for exercise, are that bpms and maximum the same than with exercise?  
When I get 180 bpm only from exercise,no anxiety,  I really feel it in the body..lack of breath and tired muscles...

Same goes for Extrayistoles, when they happen during exercise are more dangeorus than in rest?
8 Responses
1124887 tn?1313758491

I'm not a doctor, just commenting your post. It's interesting, because the same happened to me a couple of years ago. I got totally immobilized for almost a year.

Yes, anxiety during exercise (which is common, by the way, because when you exercise, heart rate increases, your breathing is deeper and more rapid, all this may mimic the start of a panic attack) will make the heart rate increase, and you can say that this increase stacks on top of the "normal" sinus tachycardia (= rapid normal heart rhythm) you get from exercise. In fact it's a bit annoying, because the normal heart rate and blood pressure increase from exercise depends on sufficient venous return to the heart. This blood is squeezed back mostly with muscle force (there are no blood pressure in the veins), so an anxiety induced tachycardia of 180 will not cause as efficient pumping as an exercise induced tachycardia of 180. This is one of the reasons people get dizzy when their heart starts to race without exercise. As a result, the body will make the heart rate increase even more to compensate, and you may end up feeling unwell.

You mention extrasystoles during exercise. I'm sure the doctor will answer this, but the general answer is yes. In your case (and mine) there may be a reason to suspect that your anxiety is creating the extrasystoles. Remember that exercise itself produces a lot of adrenaline in your body (which is usually compensated by the fact that your sinus node also speeds up (sinus tachycardia) and for that reason, extrasystoles usually "shut up" during exercise. If some parts of the heart are abnormally irritable (i.e from lack of oxygen) people can have lots of PVCs (ventricular extrasystoles) during exercise and this may be a sign of coronary artery disease or heart muscle inflammation. In your (and my) case, adrenaline can have a similar effect (upsets the heart cells). This will often trigger atrial extrasystoles (PACs), as atrial cells are often more vulnerable to adrenaline than ventricular cells. In my case, the panic produced a lot of PACs while running, and walking for that matter, so I got immobilized. Exercise, therapy and a low dosage of beta blockers fixed the issue for me.

Please be aware that adrenaline may also provoke other heart rhythms (often so-called supraventricular tachycardias) so it may be a good idea to ask your doctor for a stress test. This way, you will find out if your extrasystoles are benign PACs or not, and you will make sure the rhythm is actually sinus tachycardia.

I have a heart rate above 180 every time I do strenous exercise like running, so I wouldn't think this would be dangerous in young men. Your doctor can tell you for sure.

Just wanted to add a little of my personal experience from this before the doctor answers.
Avatar universal
Many thanks for your reply, I forgot to mention I was under Holter, Tredmill and Eco-Doppler testing and all was ok. It did happen to me when I was on the tredmill either way.

What gets me scared is that a pulse of 180 or 185, very close to my max. bpm for my age, is dangerous or not when it comes from exercise plus the adrenaline from the panic attack? Because the intensity of the exercise is medium-low, but the bpms are too high..like if i was really training hard..but I am not..I am just running slow plus anxiety attack.

In this situations I do not know what to do..stop the exercise, wear pulsometer to check when this happens to stop..or if its feels not very bad..keep runnning at same intensity.
How high the heart will go? Am I under risk...?

It is also true I do not have extrasystoles during exercise, just on rest..and even more when my stomach is not ok..
1124887 tn?1313758491
You seem carefully examinated with good results. If you got the symptoms during the stress test, it's verified to be "only" sinus tachycardia.

To put this in context, I had a heart rate above 200 with just walking when I wore my Holter. It's amazing what the anxiety can do.

My doctor prescribed a special type of beta blocker; propranolol. He adviced me to take a low dosage before exercising or when I felt anxious. It works in two ways, it 1) slows the heart rate, but also 2) reduces likelyness of panic attacks. I haven't had a panic attack since. Another advantage is that it's rapid and short acting, I took half a pill (10 mg) before exercising and it really helped me. I can't give you any medical advice, but it's maybe a good idea to ask your doctor.

I don't think a heart rate of 180 during exercise is dangerous if your heart is healthy. Personally I've stopped measuring my HR during exercise, it only scares me. I try to listen to my body, if I'm feeling exhausted I stop. As long as you don't have symptoms like dizziness or palpitations I guess it's OK, but just get it cleared by your doctor, just in case.
Avatar universal
Sorry, just to edit my previous comment, it DID NOT happen to me under treadmill test, it only happened when I was nervous or anxious...
1124887 tn?1313758491
That's quite typical. Didn't happen during my stress test either (but did at Holter).

When a doctor is nearby, we usually relax, but I've had panic attacks with both BP measurings and EKG recording. They both gave somewhat "funny" results ;)
1124887 tn?1313758491
Dear MD,

I hope you will answer his question despite my interference on this post. I apologize.
84483 tn?1289941537
In general in the absence of significant heart disease , though they feel terrible(I know) pvcs during exercise don't pose an increased as once thought!
84483 tn?1289941537
Increased risks as once thought I meant to write , I had them during a treadmill test over 10 years and was reassured about them !
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