Strong Heartbeats: When to See a Psychiatrist or Cardiologist

Q: Strong Heartbeats: When to See a Psychiatrist or Cardiologist

Hello： It is recommended that you first visit a cardiologist for an examination. <br>Additionally, issues related to the thyroid or adrenal glands may also cause symptoms such as tachycardia or palpitations, which would require an evaluation by an endocrinologist. <br>If all phys

Strong heartbeat?

Hello Doctor: I was discharged from the military at the end of 2006.
I remember that every time I returned to the base after leave, I would feel anxious, and my heart would race.
I often felt that my heart was beating very hard, and it would take me about an hour to fall asleep at night.
I wasn't completely unable to sleep, but now that I have been out of the military for almost two months, although I find it easier to sleep at home, the issue of my heart beating hard has not improved.
I'm not sure why this is happening.
Should I consult a psychiatrist for my sleep issues, a cardiologist for my heart problems, or should I see both?

Xiao Xiao, 20~29 year old female. Ask Date: 2007/01/08

Dr. Duan Yongzhang reply Psychiatry

Hello: It is recommended that you first visit a cardiologist for an examination.
Additionally, issues related to the thyroid or adrenal glands may also cause symptoms such as tachycardia or palpitations, which would require an evaluation by an endocrinologist.
If all physical examinations show no abnormalities, then it may be necessary to consider psychiatric issues, such as panic attacks, which can also lead to palpitations.
However, a definitive diagnosis can only be made through an in-person consultation.
Therefore, please start with an internal medicine consultation (cardiology and endocrinology).
After confirming that there are no physical issues, you can then visit a psychiatrist.
Regardless of the results of the physical examination, if you continue to experience anxiety and insomnia, seeking assistance from a psychiatrist is also advisable.
Thank you for your inquiry! Wishing you a speedy recovery!

Reply Date: 2007/01/08

More Info

Understanding the connection between strong heartbeats, anxiety, and potential heart issues is crucial for determining the appropriate course of action. Based on your description, it seems you are experiencing palpitations—an awareness of your heartbeat that can feel like your heart is pounding or racing. This can be particularly concerning when it interferes with sleep or daily activities.

When to See a Cardiologist
Given your history of experiencing strong heartbeats, especially during periods of stress (like returning to the military), it is wise to consult a cardiologist. They can perform a thorough evaluation, which may include an electrocardiogram (EKG), echocardiogram, or even a Holter monitor to assess your heart's rhythm over a 24-hour period. These tests can help rule out any underlying cardiac conditions, such as arrhythmias or structural heart issues, that might be contributing to your symptoms.

When to See a Psychiatrist
On the other hand, your symptoms also suggest a significant anxiety component. The fact that you felt more anxious when returning to the military and that you have difficulty falling asleep could indicate that anxiety is playing a role in your heart palpitations. Anxiety can lead to physiological changes in the body, including increased heart rate and heightened awareness of bodily sensations, which can exacerbate feelings of panic or discomfort.

If your heart is structurally normal and your symptoms persist, it may be beneficial to consult a psychiatrist or psychologist. They can help address the anxiety that may be contributing to your heart palpitations. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders and can provide you with tools to manage your symptoms better.

A Combined Approach
In many cases, a combined approach is the most effective. You might start with a visit to the cardiologist to rule out any serious heart conditions. If your heart is healthy, you can then focus on managing anxiety with the help of a mental health professional. This dual approach ensures that you are addressing both the physical and psychological aspects of your symptoms.

Additional Considerations
1. Lifestyle Modifications: Regardless of which specialist you see, consider making lifestyle changes that can help reduce anxiety and improve heart health. Regular exercise, a balanced diet, adequate hydration, and good sleep hygiene can all contribute to better overall well-being.

2. Stress Management Techniques: Techniques such as mindfulness, meditation, and deep-breathing exercises can help manage anxiety and may reduce the frequency and intensity of palpitations.

3. Monitoring Symptoms: Keep a journal of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for both your cardiologist and psychiatrist in understanding your condition.

4. Medication: If anxiety is diagnosed, medications such as selective serotonin reuptake inhibitors (SSRIs) or beta-blockers may be prescribed to help manage symptoms.

In conclusion, it is essential to address both the physical and emotional aspects of your symptoms. Start with a cardiologist to rule out any heart issues, and if everything checks out, consider seeking help from a mental health professional to tackle the anxiety that may be contributing to your strong heartbeats. This comprehensive approach will help you achieve a better quality of life and peace of mind.

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