Should I See a Doctor for My Heart Palpitations and Anxiety?

I'm not sure if I should see a doctor?

Hello, Director He.
I apologize for bothering you again, and I sincerely appreciate the valuable medical advice you provided me earlier.
I have been experiencing VPCs (ventricular premature contractions), with the highest count reaching around 600 per day.
This symptom started about a year ago and has led to anxiety and even panic attacks.
Currently, I am seeing a psychiatrist and taking 20 mg of Sertraline (Zoloft) twice a day (for serotonin) and 0.5 mg of Xanax at bedtime.
As for cardiology, I have consulted three doctors who all said I do not need medication, just to keep some Concor 1.25 mg on hand.
I am also seeing a traditional Chinese medicine practitioner to help regulate my autonomic nervous system, and my condition has improved significantly.
However, for some reason, my well-being has dropped from around 75 to about 40 over the past two days.
This started when I noticed that upon waking, my heart rate would be fast, around 120-130 after a short walk, and I felt some difficulty in breathing.
Could this lead to fainting? I feel like my body is betraying me; when I have symptoms, I tend to focus on them, which sometimes makes my heart rate increase instead of decrease, and worrying about my breathing makes it more difficult.
My temperature (ear) is 37.7 degrees Celsius, combined with difficulty breathing and a blood pressure of 143/89, which makes me anxious.
This anxiety might have caused a spike in my VPCs, which had previously been infrequent, to suddenly increase to 3-5 per minute yesterday.
I am unsure what caused this.
Am I experiencing anxiety and panic again? Should I go to the hospital for an examination? I am only 23 years old, and I really don’t want to spend my days lying in bed measuring my heart rate, blood pressure, and oxygen levels.
Additionally, I have been sweating excessively on the soles of my feet lately; I’m not sure if this is a side effect of the medication or if it’s caused by anxiety and panic.
Normally, I wouldn’t sweat like this.
I often worry about going to the emergency room, but I usually receive normal responses.
Since VPCs are an unresolved issue, even if I go to the hospital and receive a sedative, I might not feel anxious at that moment, and the VPCs could decrease, but the next day would be a new beginning, which is exhausting to think about.
I apologize for bothering you, and I truly appreciate how you respond with thoughtful answers, unlike the typical canned responses from other doctors.
You are a great physician.
Thank you, and I wish you peace!

Niming, 20~29 year old female. Ask Date: 2021/07/05

Dr. He Dongjin reply Cardiology

Hello, that's right! Anxiety and panic can indeed cause sweating on the soles of your feet.
Experiencing this 3 to 5 times a minute is not excessive, and it won't lead to death or fainting.
Try to find other goals to focus on to divert your attention.
Alternatively, you can adjust the dosage of your serotonin medication, such as Zoloft, based on the severity of your symptoms.
It won't go away completely, so try to coexist with it peacefully.
I pray for your peace.
Changhua Hospital cares about you.

Reply Date: 2021/07/05

More Info

It sounds like you are experiencing a challenging combination of heart palpitations, anxiety, and panic attacks, which can be quite distressing. Given your history of experiencing frequent ventricular premature contractions (VPCs) and the anxiety that accompanies them, it's understandable that you're feeling overwhelmed.
First and foremost, it's important to recognize that anxiety can significantly amplify physical sensations, including heart palpitations. When you become anxious about your heart rate or breathing, it can create a cycle where the more you focus on these sensations, the more pronounced they become. This is a common experience for individuals with anxiety disorders, particularly those with panic disorder.
Your current medication regimen, which includes sertraline (a selective serotonin reuptake inhibitor) and alprazolam (a benzodiazepine), suggests that you are under the care of a mental health professional. These medications can be effective for managing anxiety and panic symptoms. However, if you find that your symptoms are worsening or not adequately controlled, it may be worth discussing with your doctor the possibility of adjusting your medication or exploring additional therapeutic options, such as cognitive-behavioral therapy (CBT). CBT can help you develop coping strategies to manage anxiety and reduce the focus on physical symptoms.

Regarding your physical symptoms, such as the rapid heartbeat and shortness of breath, it is crucial to maintain open communication with your healthcare providers. Since you have already consulted with multiple cardiologists who have reassured you that your heart is structurally normal, it is likely that your symptoms are related to anxiety rather than a serious cardiac condition. However, if you experience new or worsening symptoms, such as fainting, severe chest pain, or significant changes in your health status, it is always prudent to seek immediate medical attention.

The elevated heart rate you mentioned upon waking, along with the feelings of tightness in your chest, can be indicative of anxiety or panic attacks. It is not uncommon for individuals with anxiety to experience physiological responses that mimic those of a heart condition. The key is to differentiate between anxiety-induced symptoms and those that may require medical evaluation.

As for the sweating you mentioned, it can be a side effect of anxiety or a response to the medications you are taking. If this symptom is bothersome or persistent, discussing it with your healthcare provider can help determine the best course of action.

In summary, while it is essential to monitor your symptoms and maintain regular check-ups with your healthcare providers, it is equally important to address the psychological aspects of your condition. Engaging in therapy, practicing relaxation techniques, and possibly adjusting your medication can all contribute to better management of your anxiety and its physical manifestations. Remember, you are not alone in this journey, and seeking help is a positive step towards feeling better.

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