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Heart Disease (Expert Forum)
PAT'S and Anxiety
Answered by
Cleveland - OH
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PAT'S and Anxiety
by tlg0123, Oct 31, 2005 12:00AM
I recently have been awakening at night with an overwhelming feeling of adrenaline rushing through my body then my heart begins to race. I have seen a cardiologist and was put through an excercise stress echo test. All was fine my heart rate reached 180 bpm and was sinus tach. No blockages were found and test was normal, EKG was also normal. I'am currently wearing a 30 day event monitor and at present the racing heart has been showing up as PAT's with rates up to 176 bpm. My cardiologist said that he would put me on the beta blocker 100mg Toprol XL to help alleviate this. The only problem is that I'am a 35yo female 145lbs no hx of high cholesterol, b/p normally runs 100/60 and at times even lower than this. My resting heart rate is usually 68-72 bpm. I'am an LPN and I'm currently working on getting my RN in school, my brother was recently diagnosed with Lung Cancer and just 3 weeks ago my 52yo sister died suddenly. Not to mention I am a mother of 2 ages 4 and 7. I have explained this to my Cardiologist and he still says that it is the PAT's that are causing my anxiety not my anxiety causing the PAT's. I'm concerned about taking medication that will lower my B/P more than it already is. This is begining to effect my life drastically. I'm waking up at night often as many as 4x with my heart pounding, feeling breathless, and shaking all over. It is starting to effect my daily life to the point that I shake much of the time during the day. I have a constant feeling of anxiety and adrenaline jolts. I have to do something, A just don't know what. Should I take the medication
Doctor's Answer
by Cleveland Clinic, Oct 31, 2005 12:00AM
, Oct 31, 2005 12:00AM
tlg0123,
There really isnt a risk of frequent isolated PACs with your negative cardiac work up. It really sounds like you have a lot of other stressors and this may be where you are focusing your worries and anxiety.
Although I havent seen your primary data, from what you describe I would tend to agree with your cardiologist. The Toprol may help with your symptoms/palpitations but will really have minimal impact on your anxiety so I would look seriously into ways of dealing with it.
Good luck
There really isnt a risk of frequent isolated PACs with your negative cardiac work up. It really sounds like you have a lot of other stressors and this may be where you are focusing your worries and anxiety.
Although I havent seen your primary data, from what you describe I would tend to agree with your cardiologist. The Toprol may help with your symptoms/palpitations but will really have minimal impact on your anxiety so I would look seriously into ways of dealing with it.
Good luck
I have had these episodes of PAT long before before I experience PVCs( an added misery), I had them from time I was a young boy, they are very frightening, I'll be 41 in a couple days, I too have taken beta blockers off and on since 1983. I now take atenolol 100mg daily in divided doses, I am mild/moderate hypertensive and usually have a high resting heartrate so I have to take atenolol , losartan and HCTZ for B/P control, plus to help with the PVCs and tachycardia.
Its is probably true that once you become aware of the fast heartrate and palpitations it triggers the anxiety, then in return when you get anxious it tends to trigger the tachycardia, regardless they both same to feed off each other, one thing for sure if you can ever harness your anxiety, you will probably find that you can manage the PAT alot better when you do have it and it will probably become less frequent also.Take care and good luck.
Also, like you - I had low blood pressure beforehand and it really didn't change it that much. It still runs about 90/60 and I have no low BP symptoms at all.
My internest suggested that I might want to taper off beta blockers later and I said NO WAY!! I would be a mess without them. He said that I was the first patient that had ever told him that!
Please consider trying them, I think they will help greatly!
Good luck and keep us updated!
Denise
Hang in there and know you are not alone.
Terri
I really hope that you give the Toprol or Lopressor a try. It stopped my nighttime heart racing episodes completely. I have been on Lopressor for 11 months now and I don't think I have had one episode since that time.
Remember that it will take your body a few days to adjust - you will feel sluggish for about a week - but it DOES go away, just hang in there.
Your story of your symptoms could have been written by me - it is so similar - so I really feel like the beta blocker is the answer for you as well.
Again, good luck and I would love to know how things are going for you after you try the beta blocker.
Denise
She followed its advice and slowly started to improve. Basically,
she eliminated any sort of sweet, yeast, fermented (including canned) foods from her meals. Once or twice she tried breaking this extreme regimen and the consequences were horrendous. All the old symptoms came back, the racing heart, the adrenaline rush, the sleepless nights, the constantly open pupils.
Currenly she is fine. She eats no candies, no cakes, no pies, no cookies, no ice creams, no sodas, no sugars of any kind, not even grapes. She eats no fruits that might have yeast on them from sun drying. That means no raisins, no prunes, no dried apricots, no dried fruit of any kind. She eats no fresh fruit either because it upsets her stomach unless it has been cooked. She has eliminated all salt from her diet except for what she gets in bread and she eats only one type of bread and in limited quantities (Arnold Stoned Ground Whole Wheat - two to four slices a day, sometimes with a little butter). She eats no salad dressings as they will likely have vinegar and/or sugar. She eats no cold cuts, no processed foods at all other than the bread mentioned above.
She can still eat other foods. Steamed lobsters with butter, pork roasts, chicken, turkey, hamburgers (mostly if she cooks them herself to make sure there are no additives in them). She can eat any vegetable as long as it is at least steamed if not boiled. She can eat brown rice, wild rice, kasha, potatoes, corn, squash, broccoli, brussel sprouts, string beans, etc. Occasionally we go to restaurants and she can eat the occasional roll with butter even if it is not whole wheat, but this is not an every day thing. All her restaurant meals are without sauces so any fancy dishes have to be adjusted by whoever is doing the cooking so they do not include any sugary substances or vinegars or mushrooms. She eats popcorn on occasion, if she pops it herself.
All this might seem somewhat extreme. But she is fine now. No symptoms whatsoever. As for me, I eat the same way. Initially, I did it so she would not be tempted by anything I was eating. As time passed, I started feeling better myself. More energy. Fewer illnesses. I never experienced her problems, but perhaps she is more sensitive than I am and saved us both.
I do not know if this will work for you. But it is worth a try. You must follow the regimen without cheating even once for at least two months. Granted, this will be difficult, but it does not involve drug