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Q: Anxiety and skipping heartbeats
asked by: DoctorQuestion on February 19th, 2009
I see my cardiologist tomorrow and need input. I have had symptoms that my GP and cardiologist diagnosis as anxiety. I have had blood tests, ekg and a 24hr holter monitor that were all normal. MY BP is often high at 135/90 been working to get it lower. I feel skipped beats almost every day in my throat during exercise and while doing simply nothing. At rest I can feel beats in my throat and I can confirm skipped beats taking my pulse. I used Claritin D recently once and had multiple skipped beats with dizziness. I sometimes have the urge to take full deep breaths but can’t always get that last 15% then it makes me yawn. I understand the anxiety thing but feel I would not have anxiety if I did not have these symptoms. Because of my age (36) I feel Doctors do not push extensive testing. My question is should I push for imaging or other tests (x-ray, echo, CT Scan, Monitor) other tests I have had? Or just try anxiety meds or?


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Dr. Goce Aleksovski , MD
replied on February 23rd, 2009
Heart Disease and Heart Attack Answer A5835


According to the data you provided, the reason for your symptoms might be anxiety. The anxiety might be caused by extensive physical or psychical overload. For example: not enough sleeping, continuous tension at work or at home, too much intake of substances that affect the heartbeats like coffee. Maybe you can try to notice if any of these factors are related to your lifestyle.


The feeling of anxiety makes you more sensitive to the changes of the heart that might be within normal limits. You did not specify how often you register skipping heart beats. You might ask your doctors what is the upper limit of skipping heart beats within 24 hours measured with the exact brand of Holter that was used. Then do the following math: divide the beats per minute from your ECG or the Holter with the number the doctor told you if a percentage was given. The final result will show you how often you can expect the heart to skip and not to consider it pathological.


Example: 75 (heartbeats per minute) / 1 (percent upper limit) = 75
This result means that you can expect 1 skip of the heartbeat in more than 75 heartbeats and it would not be considered pathological.


Important note: the frequency of the heartbeats changes when inhaling and when exhaling. The transition between these two phases is sometimes recognized as a heartbeat skip by inexperienced non-health-professional persons.
Also, you might want to try relaxation techniques, yoga, or something else. You might also consult a psychotherapist. Behavioral therapy might turn out to be a good solution for your problems.




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