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Suggest Treatment For High Heart Rate And Anxiety

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Posted on Wed, 28 Jan 2015
Question: Hi I get episodes where my heart rate goes up to 160 BPM. It lasts a couple of minutes and goes away. This week it has happened twice. I suffer from extreme anxiety. My question is can this be panic attacks or something like SVT? I've had a holter monitor, ECG, stress test and heart ultrasound all come back normal but I don't remember having an episode.



I also forgot to mention that I am 31 year old male. I was over weight and have lost 70 lbs in the last 9 months. This was done by changing my diet. I had a fatty liver but it has since been reversed by my change in weight and diet. I have suffered from anxiety for approximately 15 years but had it under control without medication. I had several triggers this year such as losing my job and the birth of our 3rd child which has given me more anxiety. My cardiologist did several tests on me which all came back normal. Including stress test, ECG, holter monitor, 7 day loop monitor, heart ultrasound. All came back normal. In the past I had these episodes sometimes once per month or once every two months. However I had 2 this week and 1 last week. I just wanted to know if anxiety or panic attacks can be the cause for this 160 BPM heart rate. I feel myself getting anxious and within a few seconds my heart rate shoots up. After a few minutes of deep breathing and drinking water it starts to slow down. I've heard that SVT starts and stops abruptly. I'm really scared and would love some positive feedback

Thank you
doctor
Answered by Dr. Pankaj Borade (41 minutes later)
Brief Answer:
more suggestive of anxiety disorder

Detailed Answer:
Hello,
From the given information, I can understand that your complaints are
1) palpitations
2) twice a week
3) no abnormality on investigations

Well, here I would need to know more about the associated symptoms
1) is there an associated complaints of dizziness? chest pain? breathlessness?
2) is it associated or aggravated by exertion?
3) Can you anticipate the future attack? is it triggered on exposure to any particular situation, such as on be social, or on being alone, or when in closed spaces?

The normal investigations are more suggestible of abscence of any cardiac cause and the anxiety being of psychological, however the information regarding above queries will help to strengthen specific cause.

kindly reply.
Regards,
Dr Pankaj Borade
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Pankaj Borade (9 minutes later)
Hi Doctor and thank you for your response. I do not get chest pain or breathlessness. I feel like I sort of hyperventilate because I freak out. I can almost feel it coming. I start to get nervous and within seconds my heart starts pounding hard. I have been reading a lot of articles online about possible causes and I think this has added to my anxiety. Today I was reading an online article on the couch when I started to get agitated. I actually don't get any worse when I get up. I walk around when I get like this to try to take my mind off of it. Tonight's episode only lasted 3 minutes and then it slowed down. I do not like to drive alone and it has happened to me before while driving I could feel myself getting agitated

Would my cardiologist need to catch the episode on the test in order to know? Would the normal results on all the tests be enough to know the heart is healthy?
doctor
Answered by Dr. Pankaj Borade (21 minutes later)
Brief Answer:
a possible case of panic disorder

Detailed Answer:
Hi,
Thank you for the information.
Your symptom profile is strongly suggestive of a panic disorder.
The abrupt onset, brief lasting episodes, severe anxiety and normal cardiac investigations are all suggestive of anxiety disorder, most possibly a Panic Disorder.
Well here, it is very imp on your part to know that, it's very common in general population, not a serious condition, can be adequately managed through medications and through session of Cognitive behavioural therapies.
By doing all neccesary investigations and consulting a cardiologist, it appears very clear that your heart is normal. Therefore, nothing to worry about having any heart problem.

I have some following suggestion for you
1) It will be better to consult a local psychiatrist, as a proper and detailed work up of the history, the triggering factors and associated condition( depression and phobias are common psychiatric co occurring conditions) is neccesary for complete treatment of the condition.
2) Discuss a course of SSRI group of drugs like paroxetine, etc.
3) an addition of a short acting benzodiazepines and beta blocker like propranolol can be discussed for provision of symptomatic relief.
4) In psychotherapy, sessions of cognitive behavioural therapy are known to give good results, and is advisable.

hope to have satisfied your queries.
welcome for further suggestions.
Regards,
Dr Pankaj Borade
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Pankaj Borade

Psychiatrist

Practicing since :2011

Answered : 571 Questions

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Suggest Treatment For High Heart Rate And Anxiety

Brief Answer: more suggestive of anxiety disorder Detailed Answer: Hello, From the given information, I can understand that your complaints are 1) palpitations 2) twice a week 3) no abnormality on investigations Well, here I would need to know more about the associated symptoms 1) is there an associated complaints of dizziness? chest pain? breathlessness? 2) is it associated or aggravated by exertion? 3) Can you anticipate the future attack? is it triggered on exposure to any particular situation, such as on be social, or on being alone, or when in closed spaces? The normal investigations are more suggestible of abscence of any cardiac cause and the anxiety being of psychological, however the information regarding above queries will help to strengthen specific cause. kindly reply. Regards, Dr Pankaj Borade