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Suggest Treatment For Severe Anxiety
Question: Hello, I am a 57yr old male suffering from severe anxiety. 9 1/2 yers ago I had a nuclear stress test done with no issues. My cholesterol has run in the 170-190 range since. I'm currently taking lotrel 5/10 and metoprolol 25mg for B/P. Citalapram 30mg and ativan 1mg to help me sleep. On occasion while feeling my pulse, which I do many times a day, I'll get an extra beat. My research seems to indicate a PAC. But thinking about it I'm concerned it my be a NSVT. I'm not certain if the beat goes beat...beat.beat.beat...beat or beat...beat.beat...beat. The times I caught this was never longer than 3 beats. I have a terrible phobia about heart testing, just to let you know.
Brief Answer:
Extra beats nothing to worry about
Detailed Answer:
Hi, thank you for using Healthcare Magic. It is normal to have an extra beat from time to time. These can occur from stimulants such as caffeine, stress, and other problems. You can't really tell from feeling your pulse exactly what the extra beat is. It could be a PVC or PAC. The only way to be sure what it is, and to rule out NSVT, is to have an EKG while it is occurring.
Since you have a phobia about heart testing, this puts you in a bit of a quandary. You most likely will need to have a Holter monitor to catch the irregular beat since it so occasional. That would be 24 hours or more of monitoring your heartbeat with a miniEKG machine attached to your body. This allows you to go about normal daily activities while checking the rhythm continuously.
How anxious are you about the extra beat vs anxiety about the monitoring? If you are more anxious about the beat, then get the monitoring so you can be sure and be reassured. I tend to think it's nothing serious and not NSVT based on your nuclear stress test and the infrequency of the event, and that it's your severe anxiety and your frequent checking of your pulse that is causing this concern.
However, if your anxiety disorder is going to cause you to continually focus on your pulse, the stress itself may aggravate the condition. In that case, try to overcome your anxiety about getting the monitoring done, and just be sure. You were able to go through a nuclear stress test before, so you can easily get through this, which is pretty benign. You'll be at home and in your normal environment, and will only be wearing a small pack with a few EKG leads. That should help.
Hope this answers your query. If you have further questions, I would be happy to answer them.
Extra beats nothing to worry about
Detailed Answer:
Hi, thank you for using Healthcare Magic. It is normal to have an extra beat from time to time. These can occur from stimulants such as caffeine, stress, and other problems. You can't really tell from feeling your pulse exactly what the extra beat is. It could be a PVC or PAC. The only way to be sure what it is, and to rule out NSVT, is to have an EKG while it is occurring.
Since you have a phobia about heart testing, this puts you in a bit of a quandary. You most likely will need to have a Holter monitor to catch the irregular beat since it so occasional. That would be 24 hours or more of monitoring your heartbeat with a miniEKG machine attached to your body. This allows you to go about normal daily activities while checking the rhythm continuously.
How anxious are you about the extra beat vs anxiety about the monitoring? If you are more anxious about the beat, then get the monitoring so you can be sure and be reassured. I tend to think it's nothing serious and not NSVT based on your nuclear stress test and the infrequency of the event, and that it's your severe anxiety and your frequent checking of your pulse that is causing this concern.
However, if your anxiety disorder is going to cause you to continually focus on your pulse, the stress itself may aggravate the condition. In that case, try to overcome your anxiety about getting the monitoring done, and just be sure. You were able to go through a nuclear stress test before, so you can easily get through this, which is pretty benign. You'll be at home and in your normal environment, and will only be wearing a small pack with a few EKG leads. That should help.
Hope this answers your query. If you have further questions, I would be happy to answer them.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank You Dr Steinberg.
I appreciate your thoroughness. I wish you were in my area. You seem more compassionate about my condition than my current Dr.
I appreciate your thoroughness. I wish you were in my area. You seem more compassionate about my condition than my current Dr.
Brief Answer:
You are welcome
Detailed Answer:
Glad to be of assistance. Best wishes
You are welcome
Detailed Answer:
Glad to be of assistance. Best wishes
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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