Arrhythmia and Autonomic Nervous System Disorders

Arrhythmia? Autonomic nervous system dysfunction?

Hello doctor, about 2-3 years ago, I started experiencing symptoms of chest tightness and palpitations, so I consulted a cardiologist.
I underwent a 24-hour Holter monitor, an exercise stress test, and an echocardiogram, but no issues were identified.
However, I have experienced multiple episodes at work where I felt palpitations, chest tightness, and shortness of breath to the point where I couldn't stand steadily, and the pain was so intense that it made me cry.
Last year, it was discovered that I have a 2 cm thickened heart wall, which is causing poor blood flow.
My question is whether this is related to arrhythmia and autonomic nervous system dysfunction, or if it is typical autonomic nervous system disorder, as it seems to be triggered by stress and lack of sleep.
Additionally, my symptoms are accompanied by high blood pressure, and even light jogging causes me to feel slightly breathless.
My mood swings also lead to discomfort, and I feel slightly unwell regardless of whether the weather is hot or slightly cold.

Shi Xiao Pei, 30~39 year old female. Ask Date: 2021/12/13

Dr. He Dongjin reply Cardiology

Hello, stress and lack of sleep can lead to autonomic nervous system dysfunction, which may cause arrhythmias; however, it is unrelated to left ventricular hypertrophy.
Whether there is a correlation between arrhythmias and left ventricular hypertrophy should be discussed with your attending physician, as I do not have enough information to comment on this.
Currently, it appears that the symptoms are primarily due to autonomic nervous system dysfunction.
Changhua Hospital cares about your well-being.

Reply Date: 2021/12/13

More Info

Understanding the relationship between arrhythmia and autonomic nervous system (ANS) disorders is crucial for managing symptoms like palpitations, chest tightness, and shortness of breath. Your experience of these symptoms, especially in conjunction with stress and sleep deprivation, suggests a complex interplay between your heart health and the functioning of your autonomic nervous system.

The autonomic nervous system is divided into two main branches: the sympathetic nervous system, which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system, which promotes 'rest and digest' functions. An imbalance in these systems can lead to a variety of symptoms, including those you are experiencing. Stress and anxiety can activate the sympathetic nervous system, leading to increased heart rate and blood pressure, which may explain your episodes of palpitations and chest discomfort.

Your history of heart wall thickening (hypertrophy) and the resultant issues with blood flow can further complicate this picture. Hypertrophy can be caused by various factors, including high blood pressure and increased workload on the heart. This condition can lead to arrhythmias, which are irregular heartbeats that can manifest as palpitations or a feeling of the heart racing. The fact that your symptoms worsen under stress suggests that your body’s response to stress may be exacerbating both your heart condition and your autonomic nervous system dysfunction.

Moreover, the symptoms you describe—such as feeling faint, having difficulty standing, and experiencing emotional distress—can be indicative of both autonomic dysfunction and potential cardiac issues. The autonomic nervous system plays a significant role in regulating heart rate and blood pressure, and disturbances in this system can lead to symptoms that mimic or exacerbate cardiac problems.

It is also important to consider the role of lifestyle factors, such as sleep quality and stress management, in your overall health. Chronic stress and sleep deprivation can lead to a cycle of increased sympathetic activity, which may worsen both your heart condition and your autonomic symptoms. Implementing stress-reduction techniques, such as mindfulness, meditation, or cognitive behavioral therapy, may help alleviate some of your symptoms.

In terms of management, it is essential to work closely with your healthcare providers, including cardiologists and possibly neurologists or specialists in autonomic disorders. Regular monitoring of your heart health, along with lifestyle modifications aimed at reducing stress and improving sleep quality, can be beneficial. Medications may also be considered to help manage symptoms of anxiety or arrhythmia, but these should be tailored to your specific needs and health status.

In summary, your symptoms of chest tightness, palpitations, and shortness of breath may be linked to both arrhythmia and autonomic nervous system dysfunction, particularly in the context of stress and sleep deprivation. A comprehensive approach that includes medical evaluation, lifestyle changes, and possibly psychological support will be crucial in managing your condition effectively. Always consult with your healthcare provider for personalized advice and treatment options.

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