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Having anxiety problem. Feeling high heart beat. Nuclelar stress tests, holter and echo cardiogram normal. Have PCOS. What can be done?

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Practicing since : 1966
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My name is XXXXX
I have had anxiety for about 1 year now. I do need your assistance with this. In October I went into afib, I was really stressed out that night and pretty angry my heart rate got so high and when i went to bed i woke up at 2am in afib went to the emergency and they said i will need some medicine. so they gave me some medicine, and i converted properly. Every single day afib is on my mind. I did nuclelar stress tests and also holter and echo cardiogram and everything came back fine. NOW I have been having pain, i went to ER I now have PCOS. I have chest pain right over my left rib and in the middle of my chest. What is your opinion, what can i do I cannot live like this anymore.
Posted Sun, 14 Jul 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 57 minutes later
Dear Ms XXXXX,
Welcome to Health Care Magic

Nothing to worry.
You just had one episode of A-fib! And that was transient...
Atrial fibrillation is so common – nearly 2% of the population have / or had!
It can be easily controlled – if not the rhythm, the rate...

Have a Psychiatric assessment and assistance for your Anxiety – which could account for most of the symptoms... Anxiety causes arrhythmia > Arrhythmia causes anxiety > a vicious cycle sets in. It has to be broken at some point and drugs can help...

You are unlikely to have Coronary Artery Disease – it is extremely uncommon (though theoretically possible) in young menstruating women! Nuclear stress test has excluded it for sure..

If the problem is still bothering to the extent of interfering with life style, there are advanced techniques of investigations – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS.

Relax. You are young; you sound intelligent – you stand an excellent chance of returning to normalcy.
Be positive – why fear the heart beats faster, forcible or more? The problem is only if it could not beat!
You are tolerating the rate well - means that you may not have any basic disease of the valve, muscle and so on.
Be in touch with your doctor - it is a question of time and you will be well.
Medicine is well advanced nowadays – management is possible for almost all situations...

Take care
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Having anxiety problem. Feeling high heart beat. Nuclelar stress tests, holter and echo cardiogram normal. Have PCOS. What can be done? 1 hour later
Thank you for your answer. I suppose that it is all in my head with the heart beat. I had the nuclear stress test done, the x XXXXXXX and even an echocardiogram actually I had two echos done. My doctor says there is nothing wrong with my heart, however the feelings that I feel worry me. They scare me. I did see a therapist for a while, and then when I started to work I couldn't actually go see him.
I know where my anxiety stems from, it was from a death I could not cope with. It took almost a year for it to set in and when it did It hit pretty hard. I find it hard to trust my doctor as he is super quick with me and I feel like maybe he skips these things. What would the chances of me having a heart problem after all these tests? I do have some lipid issues HDL low- LDL High and am also working on stopping smoking. I used to smoke marijuana but have stopped since I found that it made my anxiety worse.
I just want a definite answer on why I had afib, and I must admit hearing that it is common helps quite a bit. When I had the afib I saw a cardiologist who really made me more paranoid. He said things like this is not good and you probably do have CAD and we should put you on crestor. Then my family physician disagreed saying I am so young and this is manageable. I am wondering if it is possible to cure anxiety 100% without drugs, as I get so paranoid about them and habit forming as I do have a addictive personality.
I supposed my fear is of dropping dead suddenly without having a proper diagnoses. The night of my afib made my anxiety worse.
Is there anything you can recommend to me in terms of healing my body or nutrition that could promote the healing of what I am experiencing?
I constantly think of my anxiety, every single day. If not every 10 minutes some days are much easier than others. I think about my afib episode every single day not one day missed.I guess I want to know, why did the afib occur why in someone so young? I have researched and seen that most elderly people experience it but someone who is so young how odd? I guess I just want to make sure I am not affected by CAD and these pains in my chest are artificial and not an actual heart condition. The echo tests both came back clear. The holter moniter had some issues, but again could have been the palpitations I had been experiencing with the anxiety.

What do you recommend doctor?

Hope to hear from you soon.

Answered by Dr. Anantharamakrishnan 47 minutes later

Problem of the heart could be from the arteries, muscle, valves, pericardium (covering) and so on.
In your case, with these tests, the possibility of having any of these is practically NIL ...
The only issue is Electro-physiology...

It is not possible to give a definite answer as to why one had A-fib.
A few hormones – Hyperthyroidism and Pheochromocytoma – may have to be excluded...
You need to see an Electro-physiologist (cardiology sub-speciality)...

In Medicine, it is far easier to treat many issues than to find out the exact cause – a typical example is Hypertension (Blood Pressure). The investigations are often costly, cumbersome and have a very low success rate. Many may have inherited basis – and often polygenic (several genes / not manifest in relatives and so on...)

Relax – people do NOT drop dead from A-fib!
You are an unlikely candidate for CAD / And all relevant tests have excluded / If we diagnose a rare disease, we are rarely correct !

Smoking must be stopped – immediately, completely and permanently.
The same for substance abuse like marijuana...
There is no alternative.
Counselling helps here too.

Lipids can be helped by Life style modifications – diet and exercise / if necessary, drug like statin
Keep your weight to normal, even a little less
Do regular aerobic EXERCISE – say walking or jogging - 30 minutes a day / at least 5 days in a week.
You should see a good dietician – change the quantity of your food and the quality too.
Healthy FOOD is a must. Avoid saturated fats – coconut oil, palm oil, butter, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil.
Repeat the test in 6 weeks. Cholesterol can still be high, in spite of diet and exercise – you need drugs; Because it is also manufactured in the liver – and that is determined by heredity. Statin is the first choice. Some start it straight away – even with normal levels, even without problems (Primary Prophylaxis)

It is difficult to manage (leave alone cure) Anxiety without drugs – peer perseverance, friend and family backing, social support, organisational assistance, life style modification and so on have to help and be consistent...

And follow up with a cardiologist...

Above answer was peer-reviewed by
Follow-up: Having anxiety problem. Feeling high heart beat. Nuclelar stress tests, holter and echo cardiogram normal. Have PCOS. What can be done? 27 minutes later
Thank you doctor.
I appreciate your assistance deeply.
I have just finished reading the easy way by XXXXXXX car right now in the meantime of waiting your reply and now have smoked my last cigarette.
Thank you for your kindess and assistance.
Bless you.
Answered by Dr. Anantharamakrishnan 1 hour later

The first and most important step is motivation.
Now that you have shown to have it, everything will be well.
Enjoy – you have a long and happy life ahead...

God bless you
Above answer was peer-reviewed by
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