Heart Palpitations and Anxiety Medication Withdrawal

Q: Heart Palpitations and Anxiety Medication Withdrawal

Hello： Rhythm control medications belong to the class of beta-adrenergic blockers, commonly used to alleviate symptoms of chest tightness and palpitations. <br>Not taking the medication may lead to more frequent symptoms, but it is unlikely to cause severe complications. <br>This

Hello, I would like to inquire about antiarrhythmic medications?

Hello, I previously took medication for anxiety, but I had to stop because I have asthma and cannot take those medications.
I'm not sure if I stopped too quickly, as I only took them for two days before discontinuing.
After stopping, I experienced daily palpitations, irregular heartbeats, and occasionally felt like I was having myocardial ischemia, angina, or coronary artery disease pain.
I often feel weak and have difficulty breathing, which resembles pulmonary hypertension or pulmonary obstruction.
Previously, my anxiety only caused mild breathing issues, but it has now escalated to symptoms resembling heart disease, making it impossible for me to go out.
This has persisted for a year, and I frequently visit the emergency room.
Recently, I've noticed something strange: if I stay in a very hot place or eat hot food, my heart starts pounding hard, and I become extremely short of breath, to the point of feeling like I can't bear it.
It feels like my heart is going to explode.
I often wake up in the middle of the night with my heart racing, feeling exhausted and weak.
I frequently experience a sensation of pressure on my chest, which is painful enough that I can only lie down, sweating cold and feeling similar to heart failure pain.
After taking antiarrhythmic medication, I have felt somewhat better, but sometimes it doesn't seem to have any effect.
I am concerned about what would happen if I suddenly stop taking it.
Additionally, it seems that after taking the antiarrhythmic medication, my asthma has worsened, and I feel more breathless than before.
Sometimes, when my heart hurts so much that I collapse, I take nitroglycerin.

Tong He, 40~49 year old female. Ask Date: 2022/10/17

Dr. Huang Yinghe reply Cardiology

Hello: Rhythm control medications belong to the class of beta-adrenergic blockers, commonly used to alleviate symptoms of chest tightness and palpitations.
Not taking the medication may lead to more frequent symptoms, but it is unlikely to cause severe complications.
This medication does have a bronchoconstrictive effect, so it is not suitable for individuals with asthma.
Additionally, the emergency department cannot conduct a thorough examination of your condition; it is recommended that you visit a cardiology outpatient clinic for further evaluation.

Reply Date: 2022/10/17

More Info

It sounds like you are experiencing a complex interplay of symptoms related to anxiety, heart palpitations, and possibly the effects of medication withdrawal. Your situation is concerning, and it’s important to address these issues with a healthcare professional who can provide personalized advice based on your medical history and current condition.

Firstly, it’s crucial to understand that stopping anxiety medications abruptly can lead to withdrawal symptoms, which may include increased anxiety, heart palpitations, and physical symptoms such as chest pain or tightness. This is particularly true if the medication was taken for an extended period. The body can become accustomed to the presence of these medications, and sudden cessation can disrupt the balance, leading to a rebound effect where symptoms may worsen temporarily.

Given your history of asthma and the need to avoid certain medications, it’s essential to communicate openly with your healthcare provider about your symptoms and concerns. If you stopped your anxiety medication too quickly, it might be beneficial to discuss a tapering schedule with your doctor. Gradually reducing the dosage can help minimize withdrawal symptoms and allow your body to adjust more comfortably.

Regarding your heart symptoms, it’s important to differentiate between anxiety-related palpitations and those that may indicate a more serious cardiac condition. The sensations of your heart racing, feeling like it’s going to “fly out,” or experiencing chest pain can be alarming. While anxiety can certainly exacerbate these feelings, it’s crucial to rule out any underlying heart issues, especially since you mentioned experiencing symptoms akin to angina or coronary artery disease.

You mentioned that you have been to the emergency room frequently over the past year due to these symptoms. If you have not already done so, it may be worthwhile to undergo a comprehensive cardiac evaluation, which could include an electrocardiogram (ECG), echocardiogram, or even a stress test, depending on your doctor’s recommendations. This will help ensure that there are no significant heart issues contributing to your symptoms.

As for the medication you mentioned, “心律定” (likely referring to a beta-blocker), it can help manage heart palpitations and anxiety symptoms. However, it’s important to monitor how it affects your asthma. Some beta-blockers can exacerbate asthma symptoms, so if you notice increased wheezing or shortness of breath, you should contact your healthcare provider immediately. They may need to adjust your medication regimen to find a balance that manages both your heart and respiratory symptoms effectively.

If you are considering stopping any medication, including heart medications, it’s vital to do so under the guidance of a healthcare professional. Abruptly stopping medications can lead to a resurgence of symptoms or new complications. Your doctor can help you devise a safe plan for discontinuation if that is deemed necessary.

In summary, your symptoms warrant a thorough evaluation by a healthcare professional who can assess both your cardiac and respiratory health. Open communication about your anxiety, medication history, and current symptoms is key to finding an effective treatment plan that addresses all aspects of your health. It’s important to prioritize your well-being and seek the support you need to manage these complex issues effectively.

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