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Does PACs Aggravate And Precipitate Anxiety Symptoms?

Posted on Thu, 7 May 2015

Question: Hi Doctor I suffer from anxiety and lately I have been under a lot of stress. I get etopic beats or PACS and rare pvcs. I have seen a cardiologist and have done all the necessary tests. Everything came back structurally normal with my heart just the etopic beats. My cardiologist is saying they are not at all related with my heart and I don't even need a follow up. He says they are from my anxiety and occasional acid reflux. Is this possible? I started CBT therapy last week

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
PACs can precipitate anxiety attacks and you need treatment of anxiety

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. A lot of females with premature atrial contractions develop symptoms of persistent palpitations which can mimic anxiety like attacks. PACs are not considered as serious but these can aggravate anxiety. You have already done all cardiac tests and consulted a cardiologist so as per my opinion no need to worry for any heart condition. You are absolutely healthy in terms of heart condition. Occasional ectopics may result in anxiety but they are not very serious. PACs on ECG are normal findings and are not so significant.

To get rid of these beats you have to relax yourself from anxiety. CBT or cognitive behaviour therapy is one of psychological method of treatment for anxiety and depressive symptoms but this usually takes significant time to show its effects. As per my opinion you should consult a psychiatrist for your symptoms. Medicines like SSRIs should help you a lot in reducing these symptoms. SSRIs especially Sertraline can help. Sertraline is a cardiovascular safe anti anxiety drug and the drug helps to reduce the anxiety symptoms and you will feel better. Visit a psychiatrist for prescription of this drug. Continue to attend sessions of CBT and take medicines for anxiety and you will see improvement of symptoms.

As you have consulted a cardiologist and underwent all tests so as per my opinion no need to worry for heart conditions. You should not follow up cardiologist again for these PACs. Treatment of anxiety would reduce these PACs.

Thanks, Hope this helps you. Please don't hesitate to ask again for more doubts.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (1 hour later)

Hi Doctor Thank you for your detailed response. I did not know that Pacs could be a symptom of anxiety. My cardiologist says that these are not dangerous and as my anxiety subsides so will the PACS. is this true? Also are the etopic beats a common symptom of anxiety? Do you treat patients with these symptoms?

Answered by Dr. Seikhoo Bishnoi (2 hours later)

Brief Answer:
PACs can aggravate and precipitate anxiety symptoms.

Detailed Answer:
Hello again and thanks for asking a follow up question

Yes a lot of individuals with anxiety show PACs. They are found normally in a lot of individuals and are not considered as serious findings. Yes they will reduce with reduction of your anxiety. Your heart tests are normal so there should be no worry. Individuals with ectopic beats develop symptoms of anxiety because of abnormal rate and rhythm. Yes I come across such patients with these symptoms in my OPD daily. Most of them were patients referred from Cardiology or Internal medicine department.

Please don't think about these symptoms again and again because this may worsen the anxiety. You are absolutely normal.

Thanks. Please ask again if you have more doubts.

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

Above answer was peer-reviewed by : Dr. Shanthi.E