Can a panic attack do that ?

[gen2002]

Hi,  (my english is not perfect so i'll do my best) i've been dealing with lots of malaises since many years but I have more since approx. 3 years, time when I start to do some testing (i've write here in the past). I'm a 31 yo women, eat very well, my weight is ok, don't drink or smoke, one of my grandfather died from an ACV and my other grand father had a little heart problem but that's all in the family.
I've pass many tests for my heart because of many different malaises (ex. : heart that goes at 160 in the middle of the night, intolerance to exercice, heat (palpitations when it's hot, when I get up in the night and sometime just when I sit when I was sleeping my heart can go to 140), intolerance to cold etc. etc. etc.). Echo, stress test, holter ECG. All came back normal. But didn't have any kind of malaises when doing the tests so... ?

Now what happen sometimes is mostly when i'm tired, my cardiac rhythm go high for a few second then come back to normal, then go up, and down etc. For like 20 min.. And I don't feel well, I feel panicked, light headed, like i'm gonna pass out. I had these yesterday when I was driving my car, I was VERY tired since a few days but decide to go buy some things missing anyways. But it happens most of the time in the night when I sleep and wake up, feeling "weird". It never happened in the day before...
I was checking everywhere while driving to find a place to stop if something went really wrong.

I have had ALL the kinds of palpitations I think over the years. So that's why I'm freaking out like that, because it's happening for NO reason, and the symptoms are always different each time praticly :(

I've had also vagal malaise on different occasions but since 2-3 years I have them at the dentist (injection), when I have BIG emotions or see injection (like on my son) (it was not the case before at all)

I've seen an electrophysiologist that didn't want to pass others tests. She said that I probably have a problem with my baroreceptors ?! (dysautonomia ???) She didn't explain all that very well, I was not understanding.
And ask me if i'm anxious. YES anxiety is in the family. But I didn't had a lots of informations from her, I didn't have the time to explain all my symptoms either. When I said to her that I can't tolerate exercice because I feel bad and VERY exausted quickly she said that if I do exercice often, it's gonna go away with time. I didn't have the time to explain that I did the test for a  long period of time, doing exercice on a regular basis and had to stop because of the malaises and I've never seen a benefit or improvement over time from exercice :(

So she sent me see a psychiatrist at the same cardiology center. Who said that I need anti-depressor, that I have a panic trouble :( I've try 2 in the past (Celexa-Paxil) like 10 years ago after having my son (difficult time, born very premature, diagnostic of cerebral palsy etc.) and after 2 weeks, had side-effects that sent me to the ER. BIG side-effects, not normal ones at all. This time i've try Zoloft (25 mg.)and again, after 2 weeks, when I wake up in the middle of the night, I was feeling very very very weird, a nauseous feeling and very very very panicked like I've never been before, my pupils where dilated, I was not me anymore at all, I was thinking that I was becoming completely crazy, I was feeling completely intoxicated, I almost puke while calling 911 and the symptoms dissiped in approx. 20-30 min. At the ER, they said that it was a big panic attack... Not because of the Zoloft hum... But I stop them, like to others, I was really feeling TOO bad,
And the psychiatrist said the same thing for sure ! That this dose of Zoloft is like water. So praticly that it was all in my head pffff.... NO it was not at all, i've never felt this way other then when i've try anti-depressor !

Anyways... Sorry for my long message, it's difficult for me to explain well in english so it takes time.

So do you think that the "on and off bizarre" palpitations that I had yesterday can be a panic attack ? It was really like waves of palpitations and not just palpitations. I was like coming calmer in between them for a few seconds and bang, the other second, the palpitations was coming back for a few another few seconds. It was scary because I was feeling bad also and very light headed.

I've read SO many thing over the internet. I think I have dysautonomia for sure because like I said, at night when I have to get up, my heart can go as hight at 140, sometimes just to sit in the bed (like it was a BIG effort) and for this, i'm sure at 200% that it's not panic at ALL. My heart slows when i'm lying and go up again when I'm standing. But only at night and when I'm pretty awake, it pass after like 15 min.. Or in the day, if I sit for a long period, that i'm a little tired, when i'm gonna stand, my heart will go fast a little bit but in the day it replace itself quickly more than at night when I'm sleeping and my heart don't go as high.
After reading a lots of things, I was afraid that some of my palpitations where dangerous (like dangerous arrythmia or fibrillation or something like that), and i was thinking that I have cardimyopathy (praticly more than POTS), I think it looks A LOT like my symptoms and read sometimes that cardiomyopathy can be hard to detect so I was very afraid about this one :( If I had cardiomyopathy, after the tests that I done, do you think they find it ? If it's at the very begining stage ?

So what do you think about all that ?

I've take another appointment with my family doctors (who don't know nothing about all this, dysautonomia etc. he didn't know how to write it correctly, I have to say to him)... it's not reassuring for me but it's the only doctor I can go :( And i'm gonna see again the electrophysiologist in like 3 months but i don't think it will do nothing more :( And this psychiatrist don't want to see me again because she treat people that have like hallucinations and big case, not like me.

Thanks for your patience and reading me

[ireneo]

Dysautonomia is a real problem, not just in your imagination. I hope the next doctor can help with that.

As for the Zoloft, it may not be working for you. Each person is different. My husband happened use Prozac, very low dose, for a few years. It helped his depression a bit but he ended up having increased anxiety and panic attacks. And at night his body would actually jerk and tremor. There was some kind of over stimulation there from the Prozac. He was then switched to Zoloft and although it helps somewhat with the depression (not as much) at least his anxiety is not bad and he sleeps quietly. If the Zoloft is affecting you badly, they could try a different medication. Not every med if for every person, even if it is a low dose.

[gen2002]

Thanks again for all your answers I appreciate it a lot ! I've copy this message in the anxiety group as well.

For the Zoloft, I've talk with pharmacist and the doctor to see if after 2 weeks I can stop them without problem in one shot and there was no problems. Like the psychiatrist said to me, after 2 weeks it will do NOTHING at this dose, it takes like 6-8 weeks approx. to see some effect and with a bigger dose (50 mg.-100mg.) She said that if you take it for one month or less, you can stop them without cutting the dose etc. Anti-depressor stays in your body like 26 hours I think.

[achillea]

It is remarkable that you feel better the day after stopping Zoloft, because suddenly going off drugs in this class produces the following unpleasant symptoms in the majority of patients:

http://en.wikipedia.org/wiki/SSRI_discontinuation_syndrome

As you can see, this is usually quite unpleasant.

[MichelleP_3811]

It kind of sounds like you have done a lot of the tests for things that came to my mind.  I will say I have been exercising for a couple of years now on a daily basis and I really have not seen much improvement though I did smoke for 25 years and I didn't start exercising until my 40s so I may never get to the level a 20 year old can get to.  I think the main thing with exercising is if your heart rate drops at an adequate rate once you stop.  It may stay elevated for a few hours after, at least mine does, but it should drop close to where you normally are.  There is also a bit of science when it comes to cardiovascular training.  There should be a target heart rate you want to try and maintain for your age.  You should be able to find the forumula online.  This might help you achieve better results.

You may also want to check out the Dysautonomia forum on this website.  Look to the right side of the page for the Related Forums box and it will take you right to it.  Maybe you can post some of your symtoms there and find out what others who have the disorder think you should do.  But I will say I have been scared awake myself on occassion from the phone or even a bad dream and my heart will be racing so it is natural for you heart to be a bit elevated if you get stressed.  Eating a big meal might also get your heart rate up.  Finally if you find you are tend toward low blood pressure you will likely have issues when you stand up, espcially suddenly.  I can get this where I feel like I might black out if I stand too quickly.  I try to not jump up too fast but if I do I just wait for it to pass and it usually does pretty quickly.  In any event, I have heard it suggested that people with low bp adding a little salt to their diet may help but I would ask the doctor about that to make sure you don't go too far the other way.  Ok, good luck.  Keep us posted on how things are going.

[DeltaDawn23]

About the beta blocker.  I could not tolerate an extended release one -- Toprol -- even at a low dose, because it made my blood pressure too low.  But I can take Atenolol 25 mg., 1/4 of a tablet at a time.  My gamily doctor worked this out with me.  I check my blood pressure and heart rate and if they are too low, I delay the dose.  I hope this helps, the beta blocker is  relatively benign when compared with other cardiac arrthymia drugs.  Don't give up -- keep trying to find answers -- you deserve that.  I was told I was depressed, and finally that I wasn't by a psychiatrist. I take Xanax and Atenolol as well as Norpace for my arrhythmia.  Good luck -- let us know how you are.

[gen2002]

And for the Zoloft yes I start to feel better the day after I stop it ! What a crap :(  But I realise that I have problem with antidepressor only when i'm using it for like 2 weeks. Before that, the side effects where tolerable. It's like I become intoxicated and my body don't assimilate it normally. So I always ask myself WHY, there must be ANOTHER problem in me, why I don't assimilate drugs normally ?!?! :( All the people around me who took antidepressor never had SO bad side effects

[gen2002]

Thank you so much ! I'll maybe copy this message and see if there's a forum here about panic attack etc.

For the dysautonomia, I think the best doctor is the electrophysiologist to confirm that (i think ?), she know what it is, I talked with her for the tilt table test but she said that they don't do this test alot anymore because they had problems with some people where the heart completely stop :S Is there any others tests to diagnose dysautonomia ?
I don't know if baroreceptor problems VS dysautonomia is the same thing ?

Beside that, for the rest, I don't really know if it can ONLY be just anxiety problems...

My blood tests are always fine but a nurse said that sometimes, we have to do blood tests on a regular basis (like a week) too discover a problem. I never done that.

For the exercice I was doing elliptic for like 6 months, like 4 times a weeks and never seen an improvement.

My blood pressure is often low but goes high very rapidly because i'm a VERY sensitive and emotive person... I'm gonna buy yes a machine for that.

Oh and yes, I've had too the Cardio Mémo for like a month. We captures some of the big palpitations like the one who goes to 160 (when I wake up in panic because the telephone rings !!!!), we caugh up too the other palpitations (that are completely different), when I just sit or stand up at night because of the effort it goes at approx. 140 and it's not the same palpitations, my heart pump a lot less harder then when it's "panic". But these palpitations are all sinusal. For the others that come and go (up and down and up and down) no, we've not caugh up those ones.

All the doctors, cardiologist that I've seen think i'm pretty ok :( The electrophysiologist give me beta blocker but my family doctor talk with me about this and said that if I have low blood pressure, it risk to be lower with that medication and it's not gonna be good...
I don't know what to think anymore :(

[MichelleP_3811]

I personally don't know much about panic attacks but there are a few on this forum who do so hopefully they will jump on and give you some advice.  I am also not a doctor so I can't really say for certain what is going on but what I will say is based on all the tests it sounds like you have had, whatever is going on has not affected the health of your heart.  This is good but it also means there is something affecting it that should probably be tended to in some way.  Do you know if these little episodes you feel were ever caught on a monitor, either an EKG while in the ER or at the doctor's office or were you ever given a monitor to wear at home for a day or even a month?  If you know that these extreme feelings were felt while you were hooked up to a monitor then whatever is going on was captured and is not showing as something with the heart except for maybe a fast regular heart rate.  If, however, you don't believe that it was captured you may want to ask your doctor for an event monitor.  It is a heart monitor that you wear for around a month and you hit a record button when you feel one of your episodes.  The monitor will record the first minute or so before you hit the button and a little after it stops.  You would then get this recording to your doctor and they would then be able to clearly see if what you are feeling is an issue with the heart or not but until it is captured it is all just a guessing game.  

As for the exercise intolerance the doctor likely meant if you exercise for an extended amount of months rather than just doing it once in a while for a long time.  Have you dedicated yourself to an exercise routine for say at least a month and found no improvement?  In any event, the heart takes a long time to respond and get stronger so it could just be you need to give it more time to see some imporvement.  That said, it is also important that you stay fully hydrated.  If you are sick with a cold or flu and while you are exercising you need to make sure you stay hydrated.  Dehydration is a big factor in raising a person's heart rate during illness and while exercising or when in the heat.  

Has you thyriod levels been checked?  Sometimes issues with the thyroid can cause some of the symptoms you are feeling so if you haven't had your thyroid levels checked you may want to ask your regular doctor to check them to make sure you are in the right range.  

Finally do you know what your blood pressure is like?  Do you know what it is when you are feeling one of your episodes?  If you are having issues with regulating your blood pressure it could be one reason for your symptoms.  You do need to monitor it for a period of time so see if your local pharmacy has a customer monitor that you can use or consider purchasing one to monitor it at home.  

The symptoms you describe do sound like it could possibly be dysautonomia.  If you really would like to find out if that is the case with you then you might want to consider trying to find a docotor in your area who specializes in it even if it means traveling to see them.  It might be worth the effort to know for sure so you can be on the right meds to control what is going on if they are needed.

Ok, good luck.  I hope that you can get to the bottom of this and feel better soon.  Take care.

[CFS56]

I'm sorry I can't help with most of your questions but maybe I can with the  zoloft.  I tried taking zoloft and my anxiety increased a lot, I felt totally out of it, I was nauseous, had diarrhea and it caused my heart to palpitate way more than it normally does.  I only had taken it for 4 days.  So yes, zoloft can make you feel extremely weird and anxious despite what doctors will tell you.  My doc said it couldn't be the zoloft but as soon as I quit taking it I felt much better.  I am sorry you are feeling so badly and hope you can get some answers soon.