anxiety and pounding heart/tachycardia

[sandraL80]

Hi
I am a 25 year old girl, history of anxiety and panic attacks since 5 years ago, with all the classic anxiety symptoms, feeling awful. had a constant heartrate of 90-115, doc gave me a betablocker (Atenolol) 50 mg good effect. Had EKG,  echo and holter back then, everything fine. The last year I started getting fatigued (much stress in my nursingstudies) I started getting pain in my legmuscle, stopped exercising. Lots of anxiety, pounding heart, tachy, with dizziness when standing up, weakness in legs, pounding heart when switching positions, panic attacks where my heart litteraly pounds out of my throat, walking up a stair gives me tired legs (like a lactid acid feeling),
Docs say its stress/anxiety. My blood tests are all normal.
I have recently had a echo and holter, everything normal (only sinus tach. sometimes up tp 140-150 bpm-but then I was "exercising") Can this really be from alot of stress/anxiety/decontitioning? Can this damage my heart in any way? I am so scared it will give in.  My resting rate is between 70-90. Have seen an endoctrinologist and neurologist recently-everything normal, just a little elevated cortisol in stamina (caused by stress)I take 25-50 mg atenolol, and it makes me fatigued, but works in calming my heart a little (is it safe to taper them off to see if that helps?)
The most distressing symptom is my constant pounding heart (I feel every beat) I can never relax.Very typical for anxiety disorder? And can the betablocker stop working after a while? I can`t  increase the dose, as my bp goes too low. Bp now is 120/80 and sometimes lower (105/65)

Possibe  IST, POTS/DYSAUTONOMIA, CFS? Should I trust the docs diagnosis of anxiety/somatization disorder?  I eat healthy, slim, no smoking, alcohol, try to exercise but its hard because of  the tachy feeling during/ after exercise.
I also sometimes use zopiclone.
My GP says I can choose whether to take the bb or not (only sympt.treating) Can I trust that my heart is healthy?

[imagery]

I have anxiety and I used to have something called AVNRT SVT (recently ablated). The big difference between anxiety induced tachycardia and SVT is the axiety would tend to cause my heart rate to ramp up over a short period of time 75 bpm to 130 bpm. The SVT however would be instantenous, from 75 bpm to 170 bpm in one beat. It also felt funny compared to a normal sinus tachycardia caused by my anxiety.

FYI: I have ALWAYS been able to feel my heart beat. Even as a kid. I'm now a 33 year old male, have a structurally healthy heart, BP is 110/70, and cholesterol is very good.

[sandraL80]

sorry for bothering you with my questions, but is a constant pounding heart common in anxiety disorder? I often wake up with it too if the day before has been stressful

[sandraL80]

thank you!You meant that I should try quitting the betablocker and see if it helps? Will this damage my heart?

[Michael J. McWilliams, M.D.]

I am going to have to plea the fifth on this one.  I can't really assess for the difference between anxiety, dysautonomia, IST, etc over the internet.   Those are very difficult distinctions to make even if the interactions is face to face.  It is very common with those conditions for anxiety to co exist and if the anxiety is severe, it is often difficult to see past the anxiety.

The only way to know if the beta blocker will help is to try it.  IF your doctor is recommending it, it is probably a worth a shot.

I hope this helps.