To go to A & E?

[AlwaysAnxiousAnnie]

For some.time.now I've had major anxiety about my heart due to an episode last year of very bad heart palpitations, lasted hours and was so scary. It was like my heart was so out of rhythm. I went to A and E and they said it's anxiety, I've had numerous ECG, I've had a 24 hr heart monitor. They said they found nothing of concern just ectopic beats and and atrial thud. Apparently this is no cause for concern. So I was discharged from cardiology. I regularly have heart palpitations, chest pain, dizziness, breathlessness. Again it's anxiety apparently. Alas, I have developed this cardiac anxiety.
Anyway, tonight after studying up after dinner, my heart out of no where just started beating so hard and so fast in my chest. It felt like it was going to explode. Straight away I panicked, and then tried to calm myself down. I've so ce managed to calm myself but I heart beat feels all over the place. No pain or anything else. Its new Year's Eve and A&E will be busy. My DH is not very happy with me telling me not to go because it's all in my head. I've convinced myself.i won't see morning or at the very least my heart is about to give up very soon. Now I'm in this spiral of death anxiety of I could drop dead and be dead by this next time year and no one is believing me about my heart problem...am I being unreasonable to want to go to A & E and get checked out or ring 111 at th very least.. or am I just being dramatic, an anxious mess. The more I'm panicking the worst it's getting but I wasn't panicking when it first started this evening.

GPs know FA

buy yourself a kardia mobile

This is not helpful.

I'm prone to anxiety. Generally low level, but can be made worse by an event out of my control.

At least twice a week I wake up in the night with a massive panic attack - sometimes multiple times a night. It always feel like my heart has actually stopped & I can't breathe - each time feels worse, like 'this time it really is it'... but it never is, I try to regulate my breathing, breathe out etc till I've calmed down again. Nothing really helps, but I KNOW it is anxiety and I am not dying each time - so I do not worry about my heart. I don't have a heart issue (despite the awful symptoms), I have anxiety. I have had this / these symptoms for 25 years.

What I am trying to say is, try to accept that your issues / symptoms are caused by anxiety. Accept them. Sit with them.

These anxiety attacks can come on out of nowhere. I don't think you need hospital, I think you need to work on meditation and calming techniques for when this comes on. Please look at some calming meditation videos on youtube or something. I have suffered from these in the past and I too thought I was about to drop dead but that then makes it worse. You need to do everything you can to take your mind elsewhere to bring you out of it again.

OP, @QuestionableMouse has the right idea. Try to trick the vagus nerve. Fill a bowl with cold water and plunge your face in - do this for a couple of seconds then see if you can build up to five seconds.

Beta blockers help anxiety.

Beta blockers are commonly used in patients with heart rhythm disorders.

It doesn't matter whether you have anxiety or a heart problem you are going to feel better if you take the beta blocker.

If there was something structurally wrong with your heart this would have been evident on your ecg.

@Decimate do you have any further reputable sources of information on this? Not challenging you - see below.

@AlwaysAnxiousAnnie maybe of interest to you too - I'm medically trained and am awaiting my very delayed 24h tape after 2.5 months of ventricular trigeminy that basically came out of nowhere. I have anxiety issues but this did not occur during a flare.

Most suspicious to me was I was on a strict weight loss diet and I'm vegetarian. Risk of b vit and iron deficiency. Bloods at onset of symptoms showed low red cell count and low haematocrit so suggestive of early iron deficiency anaemia. I started self supplementing high dose iron (110mg ferrous fumarate every other day) before I got my ferritin checked - it was 75 by then. So there's a possibility my trigeminy was due to iron store depletion.

Lasted about 2.5 months and largely self resolved spontaneously one day. Wasn't even limited to trigeminy - getting isolated navy triplets and quadruplets I think. Was horrible and I really thought I was stuck with it! Still a few patches but massively improved.

Glad you are starting to feel better now OP!

i get these kind of symptoms as well from time to time (over 20+ years) but just wait for it to pass. I’ve had basic routine tests, but never gone to A&E or seen a cardiologist.

I would try the medication because of your level of anxiety about it, but of course your choice if you’d rather just wait these episodes out.

It may get worse with menopause, but you are hopefully a long way off!

Also @AlwaysAnxiousAnnie just want to check you had beta blockers explained to you properly by your doctor.
They're used for a wide range of conditions - they block a certain kind of receptor to adrenaline in the body.

There's a chance that the Dr told you they're for anxiety and didn't tell you they're also a prevention /treatment for many arrhythmias - both harmless ones and not so harmless ones.

Honestly if you're really struggling it would be worth trying them if you've already been prescribed them. Most people I know who take them say they're brilliant.

@ToeSucker

There's lots of info on health unlocked. I have a couple of extremely rare autoimmune diseases so have learnt to read a lot 😂
This one is useful for B12

healthunlocked.com/pasoc/posts/149815418/various-b12d-pa-resources

But there's lots of others for ferritin etc

healthunlocked.com/thyroiduk/posts/148641067/the-importance-of-getting-serum-ferritin-above-100-µg-l-for-hypothyroid-patients

@Decimate this is really interesting. Nice find!

I had a terrible attack of ectopic heart beats when I was 25. It lasted a few hours. They sent me to a cardiologist who said it was benign. My cardiologist told me that everyone gets ectopic beats, it's just some people don't notice them, and other people fixate on them.

I've experienced them ever since.

Then when I was 30 I developed SVT (heart suddenly starts beating at 240-280 beats per minute.

That was terrifying. Cardiologist said it was benign.

I've had attacks ever since.

I'm now 47. I've had ectopic beats for 22 years and SVT for 17 years. It's uncomfortable physically to have an attack, but doctors are well trained and you likely have nothing wrong with your heart.

If it's any consolation OP, my echocardiogram when I was 25, and my follow-up echo at 46 years of age both show a completely normal heart. Decades of ectopic beats and SVT haven't damaged it in the slightest. ❤️

You need to take the beta blockers. Theyre prescribed for a reason.

I have significant cardiac history at 29, which did lead to some cardiac anxiety. But I can tell you from lots of experience, an arrhythmia / cardiac event / something actually going on feels VERY different to the off ectopic beat and anxiety.

Everyone has ectopic beats. If you feel your pulse on your neck and take a deep breath in and hold it for 4 seconds you'll get one then.

You've had extensive tests done, you've been given medication. Turning up to A&E refusing to take your medication is a waste of time.

I have LQTS and SVT, it's not nice, but it was diagnosed pretty quickly, you've probably had more testing done than me.

Take your meds and go to your GP about your anxiety.

https://www.bighealth.co.uk/

Digital therapeutics to help you manage your anxiety. Please try and resist the urge to post on MN ( and especially on AIBU) when you are feeling like this. It is not helpful.

Focus instead on the support and advice you have been given by health care professionals and create a ‘bank’ of useful breathing/relaxation techniques that you can use for mental health first aid.

You NEED to try the medication that has been prescribed for you alongside all the non pharmacological things you can try.

If it has not already been mentioned: have a look at the YouTube channel of consultant cardiologist, Dr Sanjay Gupta:

https://www.youtube.com/@YorkCardiology

Lots of help info on benign palpitations, tachycardia etc.

Avoid high cocoa content chocolate, too. I find this can sometimes trigger a run of palpitations, as can a heavy meal or bending over a table, reading a newspaper, for example, can also trigger the vagus nerve.

You don't need to take a beta blocker daily - you can use one on an "as and when needed" basis when you want to steady your HR and lower it back towards normal.

Thank you. This is helpful, I have found that a heavy meal or even too much salt can trigger then. Specially if it's a very carby meal. Also, alcohol. I only drink on occasion but whenever I do my heart speeds up and starts racing. Even though I know these are triggers it still scares the life out of me.

@AlwaysAnxiousAnnie as you mention food - do you ever suffer from indigestion ? Acid reflux causes palpitations too.

Yes I do. The letter that my cardiologist sent my doctor had a list of diagnosis- which were GERD included. I had I really badly a few years ago but I never experienced palpitations as a symptom. Only extreme burning, trouble swallowing bloating etc. its calmed down a lot more now and really only flares of I eat spicy food which I avoid. I try to eat a bit healthier now as I have gallstones also so acid is a rare occurrence for me nowadays.

The other thing that helped me (I had generalised panic disorder) was exercise
Get used to your heart beating fast and breathing harder and realising it can be a good thing

Yes I know this. Its quite triggering for me though as I when I exercise and my heart rate increases I start to panic and panic that my heart won't cope with the strain and will stop so I avoid it which I know is unhealthy.

@AlwaysAnxiousAnnie

"Thank you. This is helpful, I have found that a heavy meal or even too much salt can trigger then. Specially if it's a very carby meal."

A family member has had problems with anxiety, tachycardia and palpitations this last 12 months; he did find a beta blocker helpful. He only took one or two doses on days when he needed it, so did not take them regularly.

He also has orthostatic intolerance symptoms some days and narrow pulse pressure and has found that an evening meal containing a lot of pasta seems to push his HR up afterwards, so we now limit how much pasta in one meal. Whether it's the carb load or an overly full stomach, I don't know, but a lot of carbs does seem to affect his HR. He also gets GERD.

If I have a short run of palpitations, I try singing out loud, drinking a glass of very cold water or coughing several times. (The type I have are described in one of Dr Gupta's YouTubes and resolve within a few seconds but can still be unpleasant to experience.)

Submersing your face in a bowl of cold water can also help, as the body, in these conditions, automatically reduces the HR - but I've not tried that as the palpitations resolve quite quickly.

Someone mentioned increasing exercise - even if it's just walking. It gets the body used to a normal increase in heart rate.

As others have said, a trip to A & E is unlikely to result in anything other than a long and stressful wait to be seen, monitoring of your BP, HR and temperature and possible an ECG and to be sent home with advice to take beta blockers. They won't be geared up for doing structural investigations like an echocardiogram.

Don't forget also, if you were given a 48 hour Holter monitor to monitor your heart rate at home, you might find that when you are asleep, your HR often naturally dips quite low at times and your heart copes with that every night. So I would not worry that a low dose beta blocker might send your HR too low. They are also used for people with certain heart problems to take the strain off the heart.

A low dose propranolol would take my family member's HR down from over 100bpm to around 80bpm and he'd feel a lot more comfortable.

I wish you well. Living with constant anxiety is exhausting.

@guineverehadgreeneyes

My partner has been through full cardiology workup due to lots of runs of bigeminy pvcs. Almost high enough frequency to require beta blockers due to future heart failure risk (more than just symptom management). Had echo and cardiac MRI to rule out structural issues.

He has a lot of issues with anxiety but he always says the thing that sets the ectopics off is a big meal!

Just an update. I started the beta blockers yesterday morning. I've had one today as well. This afternoon I've been having very random and abrupt heart thuds. Not Like the normal racing I get just single random thuds every so often. But really strong. I'm starting to panic and am at a loss tbh. I took th meds and it's not helped? Although am I being unreasonable to expect it to work right away?

They take a while. My DS is 28 and has been on them for 3 years because of palpitations. He gets those thuds as you describe. It's an ectopic beat. Most people get them and don't notice but when you are hyperaware because of palpitations they tend to be more noticable. You need to give them a few weeks and if after that they don't help maybe ask for a higher dose.

It's a really positive thing that you've started taking the bisoprolol.

You may need a higher dose, but give it a couple of weeks.