Q. Why do I have heart palpitations with anxiety?

Answered by
Dr. Muhammad M. Hanif Md.
and medically reviewed by iCliniq medical review team.
Published on May 11, 2018

Hello doctor,

I am 26 years old male. My weight is 240 lb and height is 5'9" tall. I have anxiety disorder for about six years now. Mostly all the time with anxiety, I have heart palpitations like I feel my heart missed a beat or it is working very slow and it starts working very fast. During this I get dizzy all the time. Palpitations happen mostly when I am laying down. For six months I was good. There were no heart palpitations. One week ago, I was sleeping and I heard someone trying to open my apartment door and I was scared. My heart stopped and I told myself that now I am going to have heart palpitations again and yes now for one week I am having heart palpitations. I feel dizzy and tired. I had ECG done couple times and nothing was found. Is this something dangerous? Will I die from it? Can I work out even if I have heart palpitations? I am very scared that whether I have heart disease. One of my reports says sinus tachycardia, possible left atrial enlargement, nonspecific T-wave abnormality, and abnormal ECG. The other one done two months after says no abnormality. Please help.

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine


Welcome to icliniq.com.

I can understand you are worried about your heart investigations. At-large there is nothing they found on later EKG (electrocardiography) report. And in both the reports (attachment removed to protect patient identity) heart markers troponin-I is normal and in range meaning, there was nothing abnormal found in the heart. In such a situation, cardiac investigation results are correlated by a cardiologist with the physical examination of the patient. This gives the whole picture of the heart.

Sinus tachycardia means the heart is pumping at the normal pattern but at a fast pace. If there is increased heart rate due to some structural abnormality or conduction defects in the heart, it does not cause sinus tachycardia. In the later tests where you mentioned, they found nothing wrong, means there was no correlation between the symptoms you felt with the heart's health and there was all fine to go with. Otherwise, they must have gone for some medications or therapy for the heart to correct any defects.

Possible left atrial enlargement, but they could not confirm that or at least it looks like from the data provided here in this query. Nonspecific T wave abnormality, they could not specify if there was the T-wave abnormality and that was linked to your health issues. If suspicious they may have gone for more investigations to rule out any issues. But they did not mean there was not much to explore and in the later evaluation, they found all fine. In such a situation and also because the reports are from long time ago, it is better to go back for a thorough heart evaluation. Your cardiologist may go for extensive heart studies including but not limited to physical examination, EKG, echocardiography, exercise stress test, cardiac markers, if needed, etc.

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

Thank you doctor,

I used to drink a lot of energy drinks before. Maybe that is why, and maybe because I was very nervous my heart rate went high. My heart rate now is around 70 to 85. But, in your experience, if I had a heart disease, will it show on my ECG?

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine


Welcome back to icliniq.com.

Yes, if there would have been something really abnormal at large they may never had it left untouched. They must have gone with it for managing it through some medications or something on that lines. You are right in saying that energy drinks play havoc with our hearts and the whole body at large. These cannot be taken in large quantities at short intervals. These are really dangerous to our heart and other vital body parts. A lot can be added to this topic but simple is that they are dangerous and are the major causative agents in raising not only our heart rates but also the blood pressure. But the good thing is their effects are reversible once we leave taking them in those large quantities. Best is plain and clean drinking water and better night’s sleep. Please do not hesitate to ask more if there are questions in mind.

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

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