Managing Panic Attacks and Heart Palpitations: A Guide for Young Adults

Autonomic nervous system, panic, missed beats?

Dear Doctor, I apologize for the interruption, and thank you for taking the time to clarify things for the public.
Allow me to introduce myself: I am a 27-year-old male with no family history of cardiovascular disease.
I have experienced panic attacks in the past, and subsequent tests revealed instability in my autonomic nervous system.
During panic attacks, I experience symptoms such as rapid heart rate, strong heartbeats, fear, numbness, and shaking.
I consulted a well-known cardiologist at a major hospital, who diagnosed me with mild mitral valve prolapse and noted a previous issue with missed heartbeats.
However, the doctor mentioned that the frequency of these missed beats, around 200-300 per day, is not concerning.
After starting medication, my condition has stabilized, and I experience very few premature contractions.
Recently, in November and December, I noticed that whenever I feel down for a few days, combined with significant changes in the weather, I am more prone to experiencing missed heartbeats in the late afternoon or evening.
These episodes last about 2 to 6 hours, during which I have intermittent missed beats, but they eventually return to normal on their own.
I would like to ask the doctor about your advice on coexisting peacefully with this condition.
If I stabilize my autonomic nervous system through adjusting my mindset and emotions, will that help? Can I continue to live my life and exercise normally? Additionally, is it possible that I will experience this for the rest of my life? I am feeling quite fearful about this.
Thank you very much for your time, Doctor.

123, 20~29 year old female. Ask Date: 2021/01/01

Dr. He Dongjin reply Cardiology

Hello, that's right.
Adjusting your mindset and emotions is important.
When the autonomic nervous system is unstable, just let it pass, similar to how we occasionally catch a cold.
It's something that can happen throughout life, so think of it as the autonomic nervous system having a "cold." Don't overthink the uncertainties of the future; instead, enjoy life.
I pray for your peace.
Changhua Hospital cares about you.

Reply Date: 2021/01/01

More Info

Managing panic attacks and heart palpitations can be particularly challenging for young adults, especially when these symptoms are compounded by anxiety and stress. Based on your description, it seems that you have a history of panic attacks and autonomic nervous system instability, which can manifest as heart palpitations, feelings of fear, and physical symptoms like numbness and trembling.
Firstly, it's important to understand that panic attacks are often triggered by stress, anxiety, or significant life changes. They can cause a range of symptoms, including rapid heartbeat, chest pain, and feelings of impending doom. In your case, the combination of emotional distress and environmental factors, such as weather changes, may be contributing to your symptoms.
You mentioned that you have been diagnosed with a mild mitral valve prolapse and occasional premature ventricular contractions (PVCs), which are generally considered benign, especially when they occur infrequently and do not cause significant symptoms. The fact that your cardiologist has reassured you about the benign nature of these findings is a positive sign. However, it is understandable that experiencing these sensations can be distressing, particularly when they coincide with feelings of anxiety or panic.

To manage your symptoms effectively, consider the following strategies:
1. Cognitive Behavioral Therapy (CBT): Engaging in CBT can help you identify and change negative thought patterns that contribute to anxiety and panic attacks. This therapeutic approach is effective in teaching coping mechanisms and reducing the frequency and intensity of panic attacks.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help calm your mind and body. These techniques can reduce the physiological response associated with panic attacks and help you regain control during episodes of palpitations.

3. Regular Physical Activity: Exercise is a powerful tool for managing anxiety and improving overall mental health. It can help regulate your autonomic nervous system and reduce the frequency of panic attacks. Aim for at least 30 minutes of moderate exercise most days of the week.

4. Healthy Lifestyle Choices: Maintaining a balanced diet, getting adequate sleep, and avoiding excessive caffeine and alcohol can significantly impact your anxiety levels. These lifestyle changes can help stabilize your mood and reduce the likelihood of panic attacks.

5. Medication Management: If you are currently on medication for anxiety or heart palpitations, ensure that you are taking it as prescribed. If you notice changes in your symptoms, discuss these with your healthcare provider. They may adjust your medication or suggest additional treatments.

6. Support System: Surround yourself with supportive friends and family who understand your situation. Sharing your experiences with others can alleviate feelings of isolation and provide comfort during difficult times.

7. Gradual Exposure: If certain situations trigger your panic attacks, consider gradually exposing yourself to these situations in a controlled manner. This technique can help desensitize you to the triggers and reduce anxiety over time.

It's also essential to recognize that while panic attacks can be distressing, they are not life-threatening. Many individuals experience them, and with the right strategies and support, you can lead a fulfilling life.
Lastly, it's crucial to maintain open communication with your healthcare provider. If your symptoms persist or worsen, or if you have concerns about your heart health, do not hesitate to seek further evaluation. Regular check-ups can help monitor your condition and provide peace of mind.

In summary, managing panic attacks and heart palpitations involves a combination of therapeutic techniques, lifestyle changes, and possibly medication. By adopting a proactive approach and utilizing available resources, you can effectively manage your symptoms and improve your quality of life.

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