Can anxiety cause heart palpitations?

Question

Hi doctor,

I am an active 30-year-old female with a history of health and generalized anxiety. For the past four days, I have been experiencing heart palpitations. Sometimes, it feels like a small flutter, as if my heart is missing a beat. Other times, it feels like an intense pounding that can last for hours. I experienced similar symptoms about seven years ago when I was first diagnosed with anxiety, but I have not felt them in a long time, so I am understandably terrified. For reference, I do not smoke or use drugs, and I work out five to six times a week (cardio, running, and weight training).

I visited a walk-in clinic doctor who listened to my heart and said that he believed the palpitations were related to anxiety. He suggested I take medication for it. I also had a chest x-ray, EKG, and blood tests, all of which came back normal. Honestly, I am terrified that I am going to have a heart attack every time I feel these palpitations.

Can these palpitations really be caused by anxiety? Should I be worried, or should I just wait for them to pass? I ran yesterday and today despite the palpitations, and I did not feel any while exercising. I only seem to experience them at rest or when lying in bed.

Please give me some peace of mind, as I am going out of my mind with worry every time I feel them.

Answer 1

Hi,

Welcome to icliniq.com.

Based on your symptoms, I do not think you should be terrified of having a heart attack. Your symptoms occur at rest, not during exertion, which is not typically associated with a heart attack. To further evaluate the palpitations, you may consider Holter monitoring. I believe your symptoms are mostly related to anxiety. I recommend keeping a diary to track what triggers or worsens your anxiety. Here are some stress management tips:

Note down the factors that disturb you, and try to either address them or ignore them.
Walk for 30 minutes daily.
Practice breathing exercises for 10 minutes twice a day.
Do yoga for 30 minutes daily.
Since you are young, consider joining a sport or physical activity you enjoy.
Listen to soft or relaxing music.
Spend quality time with your relatives and close friends, and share your concerns with them.
Seek the help of a counselor to work through the anxiety you are experiencing.

These strategies should help you find relief. Let us review your progress after two months.

Regards.