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Panic Attacks, Elevated Blood Pressure, PVCs. Normal Blood Test. What Could This Be? Treatment?

Posted on Mon, 11 Jun 2012

Question: all my blood tests have came back normal...i have severe panic attacks, and the effects last all day. it only started 3 weeks ago, but its been ever since. I deal with stress usually really well, so this is really scary. thinking i'm dying and that im having a heart attack. my heart enzymes came back good at er, but my bp is 127/99 and i have pvcs. what else could this be and how shoulod i go about treating it.

Answered by Dr. Dr. Praveen Tayal (1 hour later)

Hello,

Thanks for posting your query.

Your blood pressure is raised. You need antihypertensive drugs to control your raised diastolic blood pressure. Your doctor may do the required investigations like renal function tests and some hormone tests and then prescribe you the appropriate medicines.

Try to reduce stress by taking frequent breaks at work, get 6-8 hours of sleep daily, do Yoga, Aerobics for stress relief as well. Kindly refrain from smoking, using tobacco of any kind, avoid high calorie meals, avoid junk food, stick to a low salt diet, eat plenty of fresh fruits and XXXXXXX leafy vegetables. Drink enough water. Exercise daily by brisk walking daily for 40 minutes.
You can also ask your physician to prescribe you a mild anti anxiety drug with low day time sedation.

I hope this answers your query effectively.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Praveen Tayal (2 hours later)

the first time i went into er with these symptoms, they perscribed a higher thyroid medicine. I took it for a week, and the last 4 days i felt great...no anxiety, and pvcs were reduced a lot. then my family doc called and said to go off my synthroid for 3 days and go on a lower dose because my free t4 was a bit high. i was off for not even 2 days and i was back in er with severe panic attack and it hasnt stopped since. that was a week ago. my tsh was still good, so would the higher dose be that bad for me?

Answered by Dr. Dr. Praveen Tayal (11 hours later)

Hello.

Thanks for writing again.

Higher doses of thyroid replacement are associated with more anxiety and palpitations. The higher T4 levels are suggestive of reduced need for the hormone replacement.

There can be other reasons of precipitation of your symptoms. In your case combined treatment with medicines like one of SSRI group of medicines or a benzodiazepine depending on your case suitability along with cognitive behaviour therapy by trained therapist will be helpful.

Apart from that start practicing yoga & meditation. Consulting a psychotherapist will help your symptoms immensely.

Hope my answer is helpful.

Wish you good health.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Dr. Praveen Tayal (5 days later)

a few years back I was diagnosed with a heart valve leak that was "nothing to be worried about"...lately I have experienced panic and anxiety, and palpatations....should i be concerned that this is mitral valve prolapse? i read that those are symptoms. I have had 3 ekgs,2 chest xrays and a stress test. would it show up on those exams if i had MVP?? should i believe that it is just anxiety and panic attacks or should i think its related to the valve and heart issues?

Answered by Dr. Dr. Praveen Tayal (11 hours later)

Hello,

Thanks for writing again.

Palpitations can be caused by mitral valve prolapse. These will be precipitated with anxiety and high thyroid levels. They need to be addressed individually for complete relief of your symptom.

Plain X-rays and ECG / stress test might not be adequate to detect it palpitations. It is best to get an Echo and holter test done under the guidance of your cardiologist. These test are entailed before before attributing your symptoms to anxiety or panic alone.

Hope my answer is helpful.

Wish you good health.

Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Praveen Tayal (2 days later)

my blood tests all came back good but i have elevated monocytes...what could this mean? should i be concerned?

Answered by Dr. Dr. Praveen Tayal (7 hours later)

Hello.
Thanks for writing again.
An increased percentage of monocytes may be due to Chronic inflammatory disease, Parasitic infection, Tuberculosis, Viral infection, etc. If there are no other symptoms like fever or weakness and rest of your reports are normal then you need not worry.
It might be due to mild viral infection like cold.
Hope my answer is helpful.
Regards.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Raju A.T