You’re standing in the kitchen washing, waiting for the bus, even getting ready to go to sleep at night and there it all comes again: suddenly your pulse is pounding and racing in your chest.
We all know that our heart rate speeds up a bit with strenuous exercise, or jumps momentarily if we have a sudden scare, but what if you have palpitations with no obvious cause? Is it stress and anxiety, or could it be a problem with your heart?
Arrhythmia (the medical term for an abnormal or irregular heart rate or rhythm) is associated with a variety of potential conditions, some of which can be very serious and will need to be monitored and treated. Here’s what you need to know.
Can anxiety cause palpitations?
“Many people experience palpitations as a symptom of anxiety and panic attacks, and it is common for people to have palpitations when they are anxious,” says Yuko Nippoda, psychotherapist and spokesperson for the United Kingdom Council for Psychotherapy (UKCP).
This is due to the body’s “fight or flight” response, which can occur in times of acute stress, causing an increase in cortisol and adrenaline levels. These stress hormones can trigger a number of physiological responses, including a sudden increase in heart rate, a built-in survival mechanism that prepares us to act quickly.
Ideally, this is only temporary and things balance out again. But when people face ongoing or chronic stress and anxiety, that heightened state can persist.
Nippoda says it’s normal for people who experience anxiety-induced palpitations “to worry that there might be something wrong with their heart.”
“When they have palpitations, they may become more anxious, since the heart is a vital organ for life. However, the more anxious they are, the more likely they are to have palpitations, and this could become a vicious cycle,” he explains.
How else can you tell if anxiety is affecting your body?
If stress or anxiety is the culprit, there are likely other indicators as well. “When people have anxiety and panic attacks, they become shaky, sweaty, nauseous, tense, restless, and have a hard time sleeping. They may also have abdominal discomfort,” says Nippoda.
You may also feel tense and nervous in general, and perhaps seem more impatient and irritable and have difficulty relaxing. Sometimes it’s pretty clear that you’re under pressure and have a lot on your plate, although anxiety doesn’t always have an obvious external cause.
Always check things
All that said, as Nippoda adds: “On the other hand, palpitations can be due to a physical illness, so those who are really concerned should seek medical advice, to be on the safe side.”
When it comes to cardiac symptoms, it is always best to get a proper checkup, as soon as possible. It’s a message that Dr Oliver Segal, consultant cardiologist and electrophysiologist at The Harley Street Clinic, part of HCA Healthcare UK, also wants to highlight.
“While palpitations can certainly be related to stress or anxiety, it is not possible to distinguish between this and a genuine heart rhythm problem. Egg tracking and other tests are necessary to be sure,” says Segal.
This is especially the case if you are also experiencing other physiological symptoms.
“If you also feel short of breath, have chest pain, or feel weak, dizzy, or faint, then these are all potential red flags,” Segal says. “Symptoms that occur without stress are naturally more likely to be heart-related, as are symptoms that wake you up at night. “Exercise symptoms can sometimes be very serious and need to be monitored.”
How is arrhythmia diagnosed and treated?
Your GP will usually start by asking you about your symptoms and history, as well as listening to your heart and checking your pulse and blood pressure. Segal explains that specific tests can help detect heart rhythm problems: “Usually, an ECG, an echocardiogram (ultrasound of the heart), an ECG monitor (often a patch monitor), and blood tests are needed.”
Common arrhythmias include atrial fibrillation (AF), which causes an abnormally fast and irregular heartbeat and is particularly likely in older age groups, and supraventricular tachycardia (SVT), which causes the heart to suddenly beat much faster in bursts that last a few minutes. several hours. Heart block, for its part, is associated with an abnormally slow heart rate, sometimes also with an irregular rhythm.
Treatments depend on the type and severity of the condition, and may include medications, pacemakers, and procedures such as catheter ablation (where a thin tube is inserted through a vein or artery to correct problems with the heart’s electrical signals).
While not all arrhythmias are serious, some (such as AF) are linked to a significantly increased risk of strokes and heart attacks. “Early diagnosis and treatment can often prevent this,” says Segal. “Sometimes frequent ectopic beats can be a sign of heart failure, putting you at risk of cardiac collapse or arrest. Once again, early diagnosis is key to avoiding them.”
And if underlying heart problems are ruled out and stress or anxiety is the cause of palpitations, getting the right advice and support can also make a big difference. Breathing exercises can provide quick relief, while long-term support with talking therapies and sometimes medications can also be beneficial.
Bottom line, when it comes to heart symptoms, don’t self-diagnose.
“Self-diagnosis is never a good idea, not even for doctors!” Segal says. “We see a lot of people who waited too long to get tested and now regret that decision. It is always best to get a checkup early to be safe.”
