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Suggest Treatment For Anxiety Causing Elevated Heart Rate
Question: I am a 26 year old dealing with anxiety. I had multiple normal EKGs, Stress Test, Echo, Holter, and blood tests done 3 years ago. My anxiety relieved over the past 2 years, but recently I've been worrying again causing my heart rate to increase especially when I wake up and shower because I've been afraid to move around much. The very last time I had an EKG it was normal, but my doctor said that if I'm still experiencing anything to see a specialist just to get his opinion. Given all of the good reports, is there nothing to worry about including the rise in heart rate when showering/standing? I keep focusing on it and feeling my pulse and am ready to stop anxiety.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms do not seem to be related to any cardiac disorders.
Your cardiac performed tests can confirm that.
Anxiety seems to be the main cause of your symptoms.
You should know that some palpitations are quite normal during anxiety or physical activity.
This is a normal physiological reaction, which activates the sympathetic nervous system, thus leading to the release of catecholamines ( adrenaline and noradrenaline) in your blood.
They are responsible for tachycardia and ectopic heartbeats.
This happens also in the shower and during standing up.
But, if your heart rate raises more than 30bpm in standing up position compared to sitting position, this could indicate possible postural tachycardia (POTS) or orthostatic intolerance.
In such case a Head Up Tilt test would help rule in/out this possible disorder.
If this test results normal the main thing to do is to focus on your anxiety. Consulting with a specialist of this field (psychotherapist, psychiatrist) would help you go through this situation and manage better your anxiety.
Hope to have been helpful!
Feel free to ask any other questions whenever you need!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms do not seem to be related to any cardiac disorders.
Your cardiac performed tests can confirm that.
Anxiety seems to be the main cause of your symptoms.
You should know that some palpitations are quite normal during anxiety or physical activity.
This is a normal physiological reaction, which activates the sympathetic nervous system, thus leading to the release of catecholamines ( adrenaline and noradrenaline) in your blood.
They are responsible for tachycardia and ectopic heartbeats.
This happens also in the shower and during standing up.
But, if your heart rate raises more than 30bpm in standing up position compared to sitting position, this could indicate possible postural tachycardia (POTS) or orthostatic intolerance.
In such case a Head Up Tilt test would help rule in/out this possible disorder.
If this test results normal the main thing to do is to focus on your anxiety. Consulting with a specialist of this field (psychotherapist, psychiatrist) would help you go through this situation and manage better your anxiety.
Hope to have been helpful!
Feel free to ask any other questions whenever you need!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor and thank you for answering my question. Anxiety makes sense to me, but I guess that's the irony of anxiety in that you can't rationalize that. Given the results and lack of any symptoms for 2 years after my first bout of anxiety, any rise in heart rate when worrying or standing is not of great health concern, correct? Other than possible POTS?
The risk of sudden cardiac should be non-existent, correct? The results of all tests should be very reassuring.
The risk of sudden cardiac should be non-existent, correct? The results of all tests should be very reassuring.
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
I understand your concern and would explain that your symptoms are not related to any cardiac disorders.
It is all just pure anxiety!
You are not at a cardiac risk for heart attack or any other disorder.
So just relax! You have nothing to worry about!
As I already explained only if your heart rate raises more than 30bpm when standing up, suspension of POTS should be raised.
Otherwise, you should just try to focus on your anxiety. It is hard to believe, but anxiety can cause all this clinical scenario and much more: it can mimic a lot of other disorders.
But all your performed cardiac tests have shown a normal cardiac function and structure and have excluded coronary artery disease.
I would also recommend performing some blood lab tests ( complete blood count for anemia, thyroid hormone levels for possible thyroid dysfunction, blood electrolytes for possible imbalance) to exclude these metabolic causes that may trigger your symptomatology.
Hope to have been helpful!
Best wishes,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
I understand your concern and would explain that your symptoms are not related to any cardiac disorders.
It is all just pure anxiety!
You are not at a cardiac risk for heart attack or any other disorder.
So just relax! You have nothing to worry about!
As I already explained only if your heart rate raises more than 30bpm when standing up, suspension of POTS should be raised.
Otherwise, you should just try to focus on your anxiety. It is hard to believe, but anxiety can cause all this clinical scenario and much more: it can mimic a lot of other disorders.
But all your performed cardiac tests have shown a normal cardiac function and structure and have excluded coronary artery disease.
I would also recommend performing some blood lab tests ( complete blood count for anemia, thyroid hormone levels for possible thyroid dysfunction, blood electrolytes for possible imbalance) to exclude these metabolic causes that may trigger your symptomatology.
Hope to have been helpful!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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