I don’t want to go to A&E but I’m so bloody anxious

[ifindyouveryattractive]

Health anxiety - manifests itself in heart palpitations. I’ve been having them all ruddy day.

I spoke to an OOH GP earlier who said she’s fairly certain the trouble is panic attacks and to do a bit of deep breathing, and take PRN meds, which I’ve done. She went through my notes, I had an ECG just a fortnight ago and she said that was fine. She said A&E will be chaotic, stressful, and reinforce that there’s something to be concerned about.

I’ve been told the same in CBT before.

I’m beyond exhausted. I’m still getting fluttery heartbeats every so often. My anxious brain is saying to go to A&E and ask for another ECG, the teeny tiny sensible part is saying that I don’t need to go there and it won’t help.

I don’t feel safe going for a sleep and ignoring the feelings I’m having but I’m
so bloody tired.

Can people please stop telling OP she might have arrhythmias or some medical condition that hasn’t been diagnosed, it will make her anxiety much worse, she’s had many many many tests and all are normal, this is clearly a case of severe health anxiety (I work in cardiology and see it often).

That's a brave internet opinion. In what capacity are you employed?

What's the family history?

It’s not brave it’s pretty obvious to anyone that has any knowledge or experience of cardiology based on what OP has posted. She’s had practically every test going for palpitations (many of which she’s had repeatedly) and all have come back normal, yet people are telling OP she may have conditions such as long QT (which can cause sudden cardiac death, so quite a serious condition), which would have been very easily seen on the numerous ECGs and holter monitors she’s had, as an example.

She is being treated for anxiety and all her tests have come back normal, so telling OP she may have this condition or that condition (which would have been diagnosed through the many tests she’s had) is not helpful when someone suffers from health anxiety, it will make her anxiety worse.

I’m not going to post my job title as it’s potentially outing, however, I have a masters degree in cardiac science and work at band 7 level in the NHS and interpret most of the tests OP has had. Everything people have suggested as a potential cause of her symptoms would have been diagnosed through the tests she’s already had.

I think the numerous healthcare professionals are best placed to diagnose her given they are experts in this area and have access to her test results and medical history, random people on mumsnet casually suggesting various (often life threatening) medical conditions is not helpful, especially to someone who has severe health anxiety.

I don’t disagree that posters shouldn’t indulge OP’s anxiety. However I was 100% of the opinion that the palpitations are purely anxiety until OP mentioned she was on an mirtazapine - of which palpitations are a common side effect as I’m sure you know.

The tests OP has done prove there’s nothing wrong with her heart, however it’s possible that the palpitations are at least in part medication induced.

That would have been picked up on the holter monitors she had or the ECGs. Mirtazapine can cause long QT which results in palpitations, this can be easily seen on an ECG.

Mirtazapine can cause a long QT interval that can trigger a specific kind of tachycardia (ventricular) - but that’s rare and clearly not what’s happening here - long QT syndrome would have shown on the tests.

But aside from that mirtazapine can also cause standard palpitations with no associated serious pathology. That wouldn’t necessarily show on a 24 hour halter or an ECG. Paroxysmal arrhythmias can be hard to catch. It wouldn’t be anything to worry about but - to a person with health anxiety and a fear of palpitations - it’s worth being aware of.

Have you tried a weighted blanket? I'm autistic and find it's physical sensory things that help my anxiety. Or doing pushups because it gives proprioceptive feedback. Also things like counting backwards from 100 several times.
I too have palpitations and ectopic beats. They suck but I know they're not dangerous. I've had normal ECGs. You know you said you don't do anything to raise your heartbeat? Can you tell yourself that actually it's healthy and in fact necessary to raise your heartbeat because that's what exercises your heart.

Do tell us which test would have been guaranteed to have picked up paroxysmal AF? Then perhaps explain the concept of diagnostic overshadowing?

If don't disagree that Op's own HCPs are best placed. But I am surprised to see an HCP venturing their own firm opinion on a public internet forum. Made it immediately clear you were not a Doctor.

OP I have a temperamental heart and over the years have now realised that it is certain foods that will cause my stomach to feel weird and a bit bloated and then boom it starts my heart off so definitely something for you to consider a correlation between what you’re eating and your heart playing up - food diary might be an idea going forward

@ifindyouveryattractive how long have you had the mirena?

I only ask because I had some pretty bad anxiety for several years after DC2 was born. It very suddenly disappeared after my mirena coil was removed 5.5 years later.

I had also been doing a lot of other work to feel better, but it's a very massive coincidence and an easy thing that you could rule out.

I now have a copper coil and not a shred of anxiety.

(But also, as PP said, worth getting properly checked out too)

Considering she is phoning 111 daily at times and her palpitations are brought on by even slight physical activity she must be getting quite a lot of PAF, which would have been picked up by at least one of the three holter monitors she’s had if her symptoms are this frequent. If her symptoms were infrequent and not likely to be picked up by a holter she should have been fitted with an ILR and I imagine would have not been calling 111 daily.

The HCPs she has seen have not diagnosed any cardiac conditions despite extensive testing, she has been diagnosed with health anxiety, which along with the ectopics explains her symptoms very well, you think posters on mumsent offering random (some very serious and life threatening) medical conditions up as an explanation is helpful to someone with health anxiety?

My opinion is that suggesting random conditions, some of which are very serious and life threatening (and would have been picked up by the numerous tests OP has had))
to someone with severe health anxiety is not helpful.

Excuse me, but you offered the following opinion whilst declaring yourself an expert in cardiology: 'this is clearly a case of severe health anxiety'.

It’s what she has been diagnosed with and is been treated for and appears to accept herself given her thread opens with “health anxiety”, she has had very extensive and repeat testing for palpitations which have all come back as normal, has been seen by numerous HCPs who are not concerned about her heart, what she describes in her posts is classic health anxiety.

She posted to ask for reassurance and support with dealing with her health anxiety, which I am trying to provide by reassuring her that she’s had lots of tests which were all normal and would have picked up the conditions mentioned by posters, she’s not asking for armchair doctors to diagnose her with various cardiac conditions, which will no doubt make her anxiety even worse. I am sure posters are well meaning, but suggesting medical conditions which can be life threatening to someone who has a diagnosis of health anxiety and is asking for reassurance is not helpful.

I get heart racing with anxiety and panic attacks. If I'm not at work, I find having one alcoholic drink helps. I mean rarely, like once a month.

Otherwise I go a walk or watch youtube.

I know this sounds harsh, but it would be selfish to go to A&E. You've had a normal ECG. My sibling is a doctor in hospital and they're packed with genuinely ill patients.

Anxiety is frustrating (I'm diagnosed too) but you need therapy instead.

OP should work with her own HCP's who have access to her history and notes. You have access to neither yet are venturing a professional opinion, which makes you potentially more dangerous than other internet forums randoms.

It’s dangerous to reassure someone that a diagnosis they received following extensive investigations with numerous HCPs, and what they also accept as true is correct?

You clearly don’t understand health anxiety if you think suggesting to someone who suffers with this that they might actually have long QT syndrome instead and this was somehow missed (long QT is a serious medical problem that could cause them to suddenly die) is okay or helpful and less dangerous that reassuring them that they don’t.

I don't know if this helps at all but about 10% of men (don't have stats for women) can feel their heartbeat 100% of the time. Noticing you'd heart beat doesn't mean there is a problem. Sometimes we are just more aware.

Respectfully, you don't know what's going on and shouldn't venture a professional opinion.

Sorry for delay in replying, been a shit couple of days - hardly done anything and back to being so anxious I can’t even get to the front door. I can’t do the washing, dishes, make my bed, all sorts; because I start with ectopics again.

Ended up having a prolonged ‘flutter’ tonight that wouldn’t stop and called 999 in a panic. Because I’m in student accommodation I was able to ring security and they came round and we agreed a taxi would be better and cancelled 999. Hyperventilating in A&E. The junior doctor said he was happy to send me home as my ECG was normal. Said to see what the 72 hour monitor says.

I don’t think I’ll do much tomorrow at all but all I was doing tonight was watching TV. I was able to stand up and walk a few steps whilst the fluttering/heart pounding was happening. I don’t know. I’m exhausted of feeling this way. It’s my only thought all day long. I don’t even laugh too much now in case I get an episode.

I’m 99% it isn’t long QT. I’d have had that picked up before now if it was. I’ve been to A&E probably 10-15 times this year, and each time had an ECG and been told normal. They said there is something that’s always on my ECG about ‘reduced electrical burst’ but I don’t know what that means in reality. The doctor who told me that wouldn’t say any more about it.!

Family history is one second degree relative with arryhrmogenic cardiomyopathy and icd, another second degree with a stroke, mum has mitral valve disease. Grandparents - one died of sudden arrest after years of coronary disease, other has coronary disease at the moment.

I really hate myself as I can see I’m wasting NHS resources left right and centre and can’t seem to stop myself from being stuck on this worry. CPN said to me ‘you could have a brain bleed god forbid’ and I said to her yeah but that’s so unlikely I don’t worry about it. I don’t know why I fixate on this so much.

anyway I’ll try to reply tomorrow. Exhausted myself tonight.

Something I was told is that the symptoms of anxiety are often due to shallow breathing limiting your oxygen intake. So breath work helps. Breath in 4 hold for 7 out for 8. And repeat until breath is calmer.

Also emotional freedom technique (tapping) can help.

I’ll give that a go (breathing). Can sometimes do meditation before bed which helps. Haven’t really gotten out of bed this morning. Too scared in case the same thing happens again. It was like a prolonged ‘flutter’ that wouldn’t stop.

I spend half my day reading bloody medical journals. Doesn’t help that I have got a good anount of training in other medical stuff, just not cardiology. The doctor last night said he’d never heard of the cardiomyopathy I was talking about.

I suppose if it was serious I wouldn’t have been able to stand up when it was happening or walk to the taxi or walk into A&E, I dunno.

My CPN said realistically I’d probably never get certainty that nothing’s wrong, said I need to learn to live with that. I don’t know how other people go about their daily life not constantly worried that they’re going to drop dead, as that’s the only thought in my mind all day long.