Dr. Ilir Sharka
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I hope you can help me with my anxiety. I am a 35-year-old female who has severe health anxiety and panic disorder with agoraphobia. I have been doing good until this past month. Then, I got sick and had a fever. My heart rate was high during the time of fever. I became extremely anxious about it and went out to buy pulse oxygen to keep an eye on it. WelI I think that was a bad idea. For example, when I am up around the house cleaning, it can hit 130 beats per minute. When I am walking into someplace I have anxiety it can get up to 140 beats per minute. And I feel it. Then I get more scared. I want to start walking with my mom. But I feel scared because it may increase my heart rate. I need some reassurance as I have stuck in this heart fear. Blood pressure generally runs 107/75 mmHg and resting heart rate is around 70 beats per minute. I weight 134 lbs (60 kg), and my height is 5'3. Seven years ago I had an echocardiogram when my anxiety first started, and I wore a 30 days Holter monitor. All was good except some PVCs. I also had a stress test without contrast during that time that was also fine. I have always been scared to exercise because of the fear of my heart rate and thinking it will make me have a heart attack or go into cardiac arrest. Please, can you give me some reassurance? I came to know that I can duplicate any chest pain by pressing on the spot then snap out of thinking I have a heart attack.
Hello,
Welcome to icliniq.com.
I passed carefully through your medical history. Considering your clinical symptoms and performed medical test I would explain as follows. Your heart rate increase recently is defined by your condition of high body temperature and systemic inflammation response. Usually, there is some degree of dehydration that may also further contribute to the matter. But the primary cause of the racing heart rate is your excessive anxiety. You need to fix and avoid it. The first step is to get rid of the oximeter. You should relax and go outside in nature. Yoga and aerobics are helpful in this regard. Hope to have been of some help to you.
Patient's Query
Thank you doctor,
My general doctor told me that I am waiting for the condition to happen so whenever I start moving that happens, and I get worked up. She said that there is no reason for me to need to check my blood pressure daily nor any reason to own a pulse oximeter. The doctor also told me that many people probably hit the same numbers as me when up moving around, doing things, etc. But they do not monitor it, so they do not have anxiety about it. Would you agree with this? And would you also agree that chest pain I can duplicate is indicative of a heart attack? I will smile and work on myself if you can reassure me on those two.
Hello,
Welcome back to icliniq.com.
It is true that the heart rate is a dynamic parameter and may change over time. It usually increases with physical activity, and psychological stress may further exacerbate too. In young individuals may go even higher with physical activity. I do not see anything to worry about as your cardiac tests have resulted that everything is normal. It is difficult to duplicate chest pain when occurs due it ischemic origin. It is general, a dull and unpleasant feeling that cannot be modulated by pressing or body position. Yes, you are not at any obvious risk of a cardiac or cerebral issue. Just relax and do not worry too much about it.
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Cardiology
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