HomeAnswersCardiologyheart rateI have sudden episodes of increased heart rate. Is it related to anxiety or heart problems?

Is anxiety or heart problem a reason for increased heart rate?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At May 23, 2022
Reviewed AtDecember 5, 2023

Patient's Query

Hello doctor,

I am a 37-year-old female who recently has been having episodes of very fast heart rate; this has been happening on and off for the past weeks. It comes on very suddenly when it happens, and my heart rate goes up to 165 bpm; it is very frightening. I have been to my doctor twice, but he thinks it is anxiety, and he gave me Propranolol 80 mg modified release capsules to take every day. My heart rate is fine when I take them, and I feel calm. However, I am scared to incase it is not anxiety and there is something very seriously wrong with my heart. I had two echocardiograms last year, and they were normal; the cardiologist said there was nothing wrong with my heart and not to worry. However, I am very anxious, and I have been upset lately; it has gotten more severe. I do not know if this fast heart rate is anxiety or if something is seriously wrong with me? Would the echos last year pick up if something wrong caused a fast heart rate? I was going out of my mind with worry and scared to live my life.

Hi,

Welcome to icliniq.com.

Sudden onset of fast heart rate and sudden normalization can occur in a few conditions. I am giving you some details. SVT - This is one of the most common causes. The pulse rate is regular and fast, at around 160-200. Usually, there is no other symptom apart from palpitations. Sometimes there is dizziness. Atrial fibrillation - Paroxysmal atrial fibrillation is also a common cause. This pulse rate is irregular and fast, ranging from 120 to 180. Sometimes heart rate is normal but irregular. May accompany dizziness. Ventricular Tachycardia - This is very uncommon in structurally normal hearts but does occur. It may only cause palpitations and, on the other extreme cardiac arrest. Anxiety - There may be a normal heart rate and only feelings of palpitations or fast. Tachycardia episodes occur during sudden anxiety but subside when anxiety or fear is gone. This is diagnosis of exclusion. Other causes of persistent tachycardia include atrial fibrillation, sinus tachycardia due to anemia, thyrotoxicosis, or inappropriate sinus tachycardia. You are advised to get an ECG (electrocardiogram) done when you have a tachycardia episode. Alternatively, you can have Holter monitoring done. Are you currently taking any medicine in the long term? Are ECGs done? What other workup has been done to date? Regards.

Patient's Query

Thank you doctor,

The doctor says my pulse is fast but regular. I have had four echocardiograms in the last two years, and all are normal. I am worried sick as I am scared to incase there is a problem with my heart. My anxiety is through the roof of the situation now, and I cannot control it. When the fast heart rate happens, I feel shaky and dizzy, but I’m worrying, making things worse.

Hi,

Welcome back to icliniq.com.

I can understand your concern and feel your anxiety from your words. Taking undue stress and overthinking trivial issues will make us more sick. It is not going to solve the problems. It is better to get ECG done and exclude physical causes. Once the rhythm issue is excluded, your anxiety will decrease. If you have any issue that is causing you to get anxious, do share with me. I know mental stress is one of the main culprit to adversely affect our heart and health. If any workup is done, please share with me.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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