Heart Palpitations: Are They Linked to Anxiety? - Cardiology

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Heart palpitations can indeed be linked to anxiety, and your experience reflects a common concern among individuals dealing with anxiety disorders. When you feel your heart racing or pounding, especially during moments of stress or anxiety, it can be alarming. However, it’s essential to understand the physiological and psychological mechanisms at play.

Firstly, anxiety activates the body's "fight or flight" response, which is mediated by the autonomic nervous system. This response can lead to an increase in heart rate and the sensation of palpitations. In your case, the heart palpitations you experience, particularly when transitioning from lying down to standing up, can be attributed to the body's heightened state of arousal due to anxiety. This is often accompanied by other symptoms such as shortness of breath, sweating, and a feeling of impending doom, which are characteristic of panic attacks.

You mentioned that you have undergone various cardiac evaluations, including a 24-hour Holter monitor and echocardiograms, which have shown no significant abnormalities. This is reassuring, as it indicates that your heart is structurally normal and that the palpitations are likely not due to a serious cardiac condition. The presence of occasional premature ventricular contractions (VPCs) noted in your tests is common and usually benign, especially if your healthcare providers have reassured you about their harmless nature.

Regarding your heart rate, a resting heart rate of 90-105 beats per minute can be considered elevated, especially if you are at rest. Factors such as anxiety, dehydration, caffeine intake, or even certain medications can contribute to this increase. When you engage in physical activity, such as climbing stairs, it is normal for your heart rate to rise, but if you notice it escalating significantly or if you feel unwell during these activities, it may warrant further evaluation.

As for your question about the event monitor (the device that records your heart rhythm when you press a button), it can indeed capture episodes of arrhythmia, including any irregular heartbeats you may experience. However, the effectiveness of this monitoring depends on the timing of the event and whether you are experiencing symptoms when you activate the device. It is a useful tool for correlating symptoms with heart rhythm abnormalities.

In summary, while anxiety can certainly contribute to the sensation of heart palpitations, it is crucial to maintain open communication with your healthcare providers. If your symptoms persist or worsen, or if you experience new symptoms such as chest pain, dizziness, or fainting, you should seek medical attention promptly. Additionally, exploring anxiety management techniques, such as cognitive-behavioral therapy (CBT), mindfulness, and relaxation exercises, can be beneficial in reducing both anxiety and the associated physical symptoms.

In conclusion, while your heart palpitations may be linked to anxiety, they are generally not indicative of a serious heart condition given your normal cardiac evaluations. However, ongoing monitoring and management of your anxiety symptoms are essential for your overall well-being. If you have further concerns or if your symptoms change, consider discussing them with your healthcare provider to explore additional treatment options or referrals to specialists in cardiology or mental health.