Is it silly to worry about Brugada?

[rojo2516]

Hello Dr. I am a 33 year old male with hypertension and a bicuspid aorta. For years I have had a great deal of health anxiety (manifested in fast heart rates, occasional palpitations, maybe arrythmias? etc)  and my doctors believe that anxiety is playing a role in my hypertension. I take 25mg of atenolol and 20mg of lisinopril daily and my bp readings avg about 130/85. My problem is that I'm always scared of sudden death. I'm an athlete ( I work out 4-5 times a week) and whenever I read of an athlete suddenly dying from a heart related
problem, I'm sure it will also happen to me. I've worn holter monitors, get regular echos (due to bicuspid diagnosis), had stress echos, event monitors... and they've never really found anything - no
stenosis, cardiomyopathy etc...
So now I feel pretty comfortable that structurally my heart is fine and won't cause me problems but I still worry about an electrical problem. Would they have seen things like Brugada syndrome, or Long QT syndrome, or recognize a problem with vagal tone etc...? Should I ask to see an EP Cardiologist as well?

Basically my current symptoms are occasional flutters (especially right before I fall asleep), occasional rapid heart rate that feels "weaker" than normal, and an accompanying sensation at the base of my neck (carotid artery? vagus nerve?)

For some reason, I just can shake this fear.
thanks

[LukeL]

Instead of worrying about the super rare, worry about the common. It seems You are already doing everything you can to prevent CAD, by controlling your BP and exercising. I also assume you eat healthy and don't smoke.  I have  had an echo and well over half a dozen  EKGs and a holter. All have come back negative, yet I do still worry from time to time.

Worry is a good thing as it keeps us safe and makes us not take dumb risks, but it becomes a problem when it controls your life. You have already made the first step in admitting you have a anxiety problem.

[Michael J. McWilliams, M.D.]

If you have  standard cardiac work up and everything is fine, I would move on.  If your EKG doesn't show long QT or Brugada and you don't have  a family history of either, you are more likely to be hit by a car walking across the street then to have a rare cardiac conduction abnormality.  If your doctors don't think you need an EP consult,  you probably don't need an EP consult.  If you doctors think anxiety is problem, it might be worth trying to treat anxiety.  Anxiety tends to make people worry about problems they don't have when their are issue like anxiety that they ignore.  I am not saying this is you but it might be.

I hope this helps.