OpenHealth Q&A

Distinguishing Between Anxiety and Heart Issues: Seeking Guidance

Age: 18, Height: 5'10", Weight: 159 lbs, Ethnicity: Caucasian, Location: Brazil. I'm generally fit and engage in running and weight training. Lately, I've been grappling with personal challenges that have taken a toll on my mental well-being and disrupted my daily life. The saga began a fortnight ago when I experienced my first panic attack, which led me to believe I was suffering from a heart issue. My heart raced at approximately 120 beats per minute, and I faced shortness of breath along with overwhelming fear. My parents quickly took me to the emergency room, where the findings were reassuring: blood pressure was at 130/70, oxygen saturation sat at 97%, and my ECG results were clear. Despite this, I remained anxious until I received a calming medication. After that, I was able to rest and felt normal in the following days. However, during a trip, my anxiety resurfaced. I found myself fixating on the idea that the airplane might crash, which only heightened my fears. I managed to avoid panic attacks until the eve of my return home, when I suffered an anxiety episode characterized by chest pressure, shaking, and breathlessness. To cope, I took Valeriana, a natural sedative available here, attempted to distract myself, and managed about five hours of sleep. The next night proved to be even more challenging. Preparing for my flight back, I once again succumbed to the belief that the plane was doomed. My heart raced relentlessly. Upon arriving home, I was struck by another panic attack. My brother utilized his Samsung Galaxy Watch to conduct an ECG, which indicated I had Atrial Fibrillation. This revelation exacerbated my anxiety as I felt lightheaded, struggled to breathe, and experienced significant heart palpitations. We hurried back to the hospital, where another ECG was performed—once again, the results were normal. I consulted with a physician who specializes in both cardiology and psychiatry, who prescribed Desvenlafaxine and Omeprazole (to combat expected nausea). The next four days were unbearable—marked by insomnia, relentless anxiety, and overwhelming fatigue accompanied by feelings of nausea. At last, I had an appointment with a psychiatrist, who adjusted my medication and diagnosed me with Generalized Anxiety Disorder (GAD). Currently, my regimen includes 1 mg of Alprazolam and one pill of Escitalopram (ESC) each day. The first dose of Alprazolam significantly alleviated my symptoms; I was contending with chest pressure and shortness of breath, but after taking the medication, my symptoms eased, allowing me to sleep soundly. Soon after, I revisited the cardiologist, who noted I had isolated supraventricular extrasystoles—something benign—and recommended a 24-hour Holter monitor and HDL test just in case. However, I continue to experience occasional odd sensations: sporadic palpitations, subtle chest pressure, and fleeting shortness of breath, but my oxygen levels remain stable. I even ran 5.3 km today without any issues, reaching a heart rate of 183 bpm, yet I still deal with persistent worry about my heart health. This morning, my resting heart rate was between 48 and 55 bpm, and I experienced slight dizziness when I sat up. Interestingly, my Galaxy Watch detected atrial fibrillation three times while I was merely seated. My wrist was resting lightly, but those readings triggered a fresh wave of anxiety. As a point of reference, I do not smoke, avoid alcohol, maintain normal cholesterol levels, and my risk for heart disease is low. I’ve had three medical consultations along with two ECGs; on the third visit, the doctor opted not to conduct an ECG, instead prescribing calming medication. Additionally, I have no family history of heart disease prior to the age of 60. So, I am reaching out for your thoughts: Is this all rooted in anxiety, or is there a more serious concern, such as Atrial Fibrillation or a hereditary heart condition?

Answers (1)

8/2/2025, 4:10:59 PM

OpenHealth AI

It's understandable to feel overwhelmed when managing both anxiety and concerns about your heart health, especially after experiencing distressing symptoms. Let’s break down your situation:

Main Points

1. Anxiety and Panic Attacks: Your experiences, including high heart rate, shortness of breath, and overwhelming fear, are consistent with anxiety disorders, particularly Generalized Anxiety Disorder (GAD) as diagnosed by your psychiatrist.
2. Heart Concerns: The medical evaluations you underwent—including normal ECG results and reassurance from your cardiologist about benign supraventricular extrasystoles—point towards a low risk of serious heart conditions.
3. Management Strategies: It’s important to focus on effectively managing your anxiety while maintaining heart health.

Explanation

Your symptoms can indeed be very distressing, and the interplay between anxiety and physical symptoms can create a cycle of fear—often leading you to misinterpret normal sensations (like palpitations) as serious heart issues. You’ve been cleared of significant heart problems through thorough medical investigation, including reassurance from specialists.

Given your active lifestyle, lack of traditional risk factors for heart disease, and normal test results, it seems your symptoms are more aligned with anxiety rather than a serious heart condition.

Next Steps

1. Continue Medication as Prescribed: Stick to your regimen of Escitalopram and Alprazolam, as these medications can help manage your anxiety. If symptoms persist or worsen, discuss them with your psychiatrist for potential adjustments.
2. Monitor Your Symptoms: Keep a daily log of your heart rate, any episodes of palpitations, and anxiety levels. This can help both you and your healthcare providers understand patterns over time.
3. Practice Relaxation Techniques: Incorporate relaxation strategies such as deep breathing exercises, mindfulness, or meditation to help reduce anxiety and mitigate physical symptoms. Apps or guided sessions can be helpful.
4. Physical Activity: Engage in regular exercise, which you’re already doing with running. Ensure it remains at a comfortable intensity, and consider activities like yoga or tai chi that combine physical movement with relaxation.
5. Educate Yourself: Learn more about anxiety and how it manifests physically. Understanding that anxiety can produce real symptoms might help reduce fear and worry.
6. Social Support: Talk openly with family or friends about your experiences. Sometimes, sharing your thoughts can lessen the burden and provide emotional support.
7. Follow-up with Healthcare Providers: Stay connected with both your psychiatrist and cardiologist for ongoing monitoring and reassurance.

It’s positive that you remain physically active and have sought professional help. Focus on your mental well-being and practice self-care; gradual improvement is the goal. Remember, you can reach out if you have further questions or need support in navigating your health journey.