Q. I felt as if my heart stopped beating. Could this be a panic attack symptom?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by iCliniq medical review team.
Published on May 12, 2018

Hello doctor,

I wanted to know if you could answer one question for me. I experienced an episode that lasted roughly about two to three minutes where I felt that I could not seem to catch my breath and it felt as if my heart had stopped beating. I checked my heart rate roughly three minutes after the incident and it was at 60 bpm and my oxygen was at 99 % under two weeks ago. I had a routine 24 tape which was clear (ectopic beats picked up but were benign). I suffer from anxiety and panic attacks. However, they generally come on during stressful situations. Could this be a panic attack symptom? I also wanted to add that this happened during intercourse (I am a 35-year-old male, height is 174 cm and weight is 100 kg). I look forward to your response and suggestions.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome to icliniq.com.

This can be a cardiac arrhythmia like PSVT (paroxysmal supraventricular tachycardia) or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. And one may get symptoms like shortness of breath, chest pain or heaviness, dizziness, etc. Are you having ventricular or atrial ectopics? Have you undergone echo? Presence of ectopics also suggests the possibility of these arrhythmias.

Usually, ECG is normal (attachment removed to protect patient identity) as it is done in between the episodes or may show ectopics. ECG done during episodes will show abnormality. You may request for portable cardiac monitor either Holter or another mobile-based rhythm monitor especially during intercourse to see the rhythm is recurring. Alternatively, you may undergo treadmill test and we can see if it recurs during the running.

Also, thyroid test should be done if not had recently. ln order to abort such episodes you should try to cough hard. Next time, you have this, focus on heart rate and measure pulse rate. These arrhythmias are not life-threatening. So overall, that episode may be an episode atrial arrhythmia rather than panic attack and our priority is to confirm it by investigations. Hope this helps you and get back if you have any doubts.

For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

Hi doctor,

Thank you for your response. I had added that I recently had a Holter monitor two weeks ago which came back normal as well as a thyroid test which was normal. Regarding an echo, I had one year ago which again was normal. Should I have it performed once a year? I have been advised that my epilogue beats were benign. Please advise me what tests I can have that will determine my heart health as well as what does a place year tell you and is it worthwhile having it done.

If a person has smoked for 16 years (one pack a day) and has stopped for almost six years, will the damage done be reversed to that of a non-smoker? Lastly, are heart attacks common in 36-year-old white males?

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome back to icliniq.com.

No, you do not need another echo. ECG done or Holter attached during the episode will only show abnormality as it is a transient episode. So you should try having another intercourse and see if it recurs during intercourse. If it recurs then you should get Holter attached and have again intercourse to provoke that episode, and then it can be caught on Holter. If it is not recurring then you better have treadmill test to see if it comes back to running on a treadmill. If these are not successful, then you should have extended ECG monitor attached like AliveCor Kardia monitor which is mobile based monitor and you can put it while you are at home and they will monitor your rhythm.

Yes, quitting smoking reduces risk significantly and it nearly reaches to nonsmoker after 10 to 15 years. Heart attack are not common in this age group but does occur. But, your symptoms are not of heart attack and it is not a heart attack. Arrhythmias are different from a heart attack and what we are suspecting you is not life-threatening.

For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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