Is It Autonomic Nervous Disorder or Heart Disease? Your Symptoms

Is it autonomic nervous system dysfunction or heart disease?

I tend to get anxious and often experience insomnia.
Recently, I've been feeling my heart beating strongly and quickly.
My blood pressure readings are around 130/80, but it often tends to be higher, around 150 when I'm not on medication.
I previously consulted my family doctor, who prescribed antihypertensive medication.
Later, I saw a cardiologist, and after an echocardiogram, no heart issues were found, so I was prescribed propranolol, which is a medication for heart rate regulation, to be taken only when I feel uncomfortable.
Should I continue seeing a cardiologist, or should I consult a psychiatrist?

111, 20~29 year old female. Ask Date: 2016/07/05

Dr. He Dongjin reply Cardiology

Hello, it seems that you are experiencing autonomic nervous system dysfunction rather than a heart condition.
You may consult either a cardiologist or a psychiatrist, and there is no need to take blood pressure medication.
Propranolol should be an appropriate medication.
Ping An Changhua Hospital cares about your well-being.

Reply Date: 2016/07/05

More Info

When it comes to distinguishing between autonomic nervous system disorders and heart disease, it is essential to consider both your symptoms and the results of your medical evaluations. Based on your description, it seems you are experiencing significant anxiety, which is often linked to autonomic nervous system dysregulation. This can manifest as palpitations, increased heart rate, and elevated blood pressure, particularly in stressful situations or when you are feeling anxious.

Your blood pressure readings, particularly the higher ones (around 150/80), suggest that you may be experiencing episodes of hypertension, which can be exacerbated by anxiety. The fact that your heart ultrasound did not reveal any structural heart issues is reassuring and indicates that there is likely no underlying heart disease. The prescription of propranolol, a beta-blocker, is commonly used to manage symptoms of anxiety, such as palpitations and tachycardia, by slowing down the heart rate and reducing the force of contraction.

Given your history of anxiety, insomnia, and the physical symptoms you are experiencing, it would be prudent to consider a multidisciplinary approach. While it is essential to monitor your heart health, especially since you have been prescribed medication for blood pressure, it may also be beneficial to consult with a mental health professional. Anxiety disorders can significantly impact physical health, leading to symptoms that mimic those of heart disease, such as chest pain, shortness of breath, and palpitations.

Cognitive-behavioral therapy (CBT) is an effective treatment for anxiety and can help you develop coping strategies to manage your symptoms. Additionally, lifestyle modifications, such as regular exercise, a balanced diet, and good sleep hygiene, can also play a crucial role in managing both anxiety and blood pressure.

It is important to maintain open communication with your healthcare providers. If you continue to experience symptoms or if they worsen, follow up with both your cardiologist and a mental health professional. They can work together to ensure that you receive comprehensive care that addresses both your physical and mental health needs.

In summary, while your heart evaluations suggest that there is no significant heart disease, your symptoms may be more closely related to autonomic nervous system dysfunction, likely exacerbated by anxiety. A combined approach involving both cardiology and mental health support may provide the best outcome for your overall well-being.

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