Question Title: Heart, anxiety or both?

To put it bluntly I have been through hell for the past 7 years. I awoke one night to a racing heart beat of 170. To make a long story short, i have continued to have heart problems (Tachacardyia, PVC's,) ever since. My major complaint has always been chest pain. This pain starts whenever my adrenalin "goes off". I feel an adrenalin release and then I have a squeezing pain between my shoulder blades in the back for a few seconds with each wave of adrenalin. Usually when this happens I take a Xanax and/ or nitroglycering and the pain goes away.
This has had a profound effect on my life. I have begun to wonder if this is a psychiatric complaint, a cardiac ailment or a combination of both...I have had a cardiac catheterizaion 3 years ago that was normal. Possible diagnosis has been coronary artery spasm, panic attacks, a combination of both and MVP.
i have had my adrenalin tested and it was normal. Why would my adrenalin release ALL THE TIME? Would this be anxiety related? Currently I am on Toprol (50mg), Xanax (.5), Imdur (which doesn't help) and recently started Zoloft (50mg).
Sorry this is so long, but could anxiety be causing all of my symptoms or for instance, could anxiety trigger some cardiac problems?

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Dear Heather,

Anxiety can manifest itself in many forms, including physical symptoms. Panic attacks, a form of anxiety, can be characterized by symptoms such as palpitations, pounding heart, accelerated heart rate and chest pain or discomfort among many other symptoms. Panic attacks are disrete episodes that reach a peak intensity within seconds or minutes and usually subside in minutes to hours. When panic attacks are recurrent and lead to persistent worry about having additional attacks, or worry about the implications of the attack(such as losing control), or cause a significant change in behavior, the diagnosis of Panic Disorder is considered. It is difficult for me to say whether the symptoms you experience are related to anxiety, a medical condition or possibly both. Several medical conditions can mimic or be co-morbid with panic disorder, including cardiac arrhythmias and mitral valve prolapse.

I would recommend that you continue to see your primary physician for continued monitoring and treatment. You are currently on Zoloft, which is indicated for the treatment of panic disorder. I would recommend also to follow up with a mental health professional who can aid in the diagnosis, monitor your psychiatric medication and teach you methods of reducing anxiety, such as relaxation.

I hope that this information has been helpful to you. It is provided for educational purposes only, and should not replace consultations with your doctors. If you wish to see a mental health professional at Henry Ford Hospital, please call 1-313-874-6680 for an appointment.

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