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How to manage anxiety with constant tachycardia?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am a 24-year-old female who has been experiencing episodes of tachycardia and ventricular ectopic beats for the past two years. I have undergone many tests on my heart, including various ECGs, a 24-hour heart monitor, a five-day heart monitor, a seven-day heart monitor, and an echocardiogram. All of these tests came back normal, except for occasional ectopic beats and episodes of tachycardia ranging from 100 to 160 bpm.

Recently, my ectopic beats have become much more intense. By this, I mean that I feel a very strong thud in my chest that leaves me feeling lightheaded and shaken. I have visited the doctor, but no conclusive findings have been made. I suffer from chronic anxiety and feel as though I am not truly living my life because of this condition and the persistent tachycardia.

Could you provide me with some advice?

Hello,

Welcome to icliniq.com.

Your reports (attachment removed to protect patient identity) appear to be normal, except for the presence of ectopic beats and probable sinus tachycardia, both of which are typically benign. If you have not done so recently, you should have your thyroid function and hemoglobin levels tested. It is important to reassure yourself that these findings are harmless and will not cause any long-term harm. You should discuss with your doctor the possibility of withholding Salmeterol or using it at the minimum effective dose, as it can cause or worsen these symptoms. Additionally, reducing your coffee intake may help alleviate your symptoms.

If the symptoms are particularly bothersome, you should also consult your doctor about starting beta-blockers or calcium channel blockers, which can help reduce these episodes, provided they are not contraindicated in your case.

Kind regards.

Patient's Query

Hello doctor,

Thank you for the reply.

This is reassuring. Do my QT intervals look normal on these ECGs? I was once told that my QTc was 560, which really panicked me, but it is usually normal. I worry about the risk of dying from long QT syndrome. Should I also be concerned if my ectopic beats become more intense and forceful?

Hello,

Welcome back to icliniq.com.

The QTc is normal in the attached tracings, so it is unlikely that you have long QT syndrome, and the risk of dying from it is very low. Since you do not have any structural heart disease, ectopic beats are not a cause for concern, even if they feel intense or forceful. You may consider using mobile-based ECG monitors, to track their frequency at home.

I hope this helps you.

Thank you.

Medically reviewed byDr. Divya Banu M

Published At February 8, 2020
Reviewed AtJanuary 23, 2025

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