Can arrhythmia occur due to stress?

Question

Hello doctor,

I am 27 years old, and I have been struggling with OCD and health anxiety for many years. For about a year now, I have been experiencing arrhythmia (mostly extrasystoles), but these have mostly improved since I started my new job. However, something still does not feel right. I have been feeling chest discomfort (angina) for over a month now, with occasional extrasystoles, and I am finding it difficult to focus on my work.

I had an ECG done five months ago, which showed everything was normal. But I had another ECG done two days ago, and now I am really concerned since I can only see the cardiologist tomorrow. The ECG revealed ischemia in the inferior wall, which I think is in the V1 lead. Could this be related to all the emotional stress I have been experiencing? What can help me calm down and reassure me that it is not something too serious?

Answer 1

Hello,

Welcome on icliniq.com.

Regarding your concern, I would explain that a direct review of your electrocardiogram (ECG) recordings is necessary to accurately assess their clinical significance.

Answer 2

Hello,

Welcome back to icliniq.com.

I reviewed your ECG strips (attachment removed to protect patient identity) and would like to explain that there are ST-segment depressions in the inferior leads (D2, D3, aVF), along with diffuse T-wave flattening. While the previous ECG is not fully visible, further clinical investigation is needed regarding these recent findings. Similar ECG changes are not uncommon in women with completely normal coronary arteries, mitral valve prolapse, etc. At this point, I would recommend discussing with your doctor the possibility of conducting further cardiac tests, such as a cardiac ultrasound, exercise cardiac stress test, and, if necessary, a cardiac MRI, should concerns about cardiac structure arise. On the other hand, the sinus arrhythmia detected in your ECGs is not a cause for concern, as it is frequently observed in healthy young individuals. You should discuss the issues mentioned above with your doctor.

Thank you.