Is It Panic Attack or Heart Rhythm Disorder

Many people with anxiety and panic attacks often have racing heart associated, sometimes with shortness of breath and dizziness. These symptoms may overlap with a condition called SUPRAVENTRICULAR TACHYCARDIA OR SVT.

This condition occurs when faulty electrical signal in the heart override the heart’s normal pacemaker or electrical conduction system, and this triggers a series of fast heartbeats. During an episode of SVT, the heart rate can go up as high as 250 beats per minute or more and people may have multiple symptoms.( normal heart rate is between 60 to 100 bpm.).

When this happens, the hearts’s lower chamber called ventricles don’t have enough time to fill up with blood in between heartbeats. As a result, the brain and body may receive less blood than normal, and this may result in light headedness. Other symptoms that can occur with both SVT and a panic attack include sweating, choking sensation, chest pain, weakness.

During panic attacks, people may also experience feeling of impending doom and helplessness. Both panic attacks and SVT tend to be more common in women. Often in young women, SVT is often misdiagnosed as anxiety or panic attack, but this may happen in people of all ages. Most of the episodes of SVT start abruptly and end abruptly. However, many times they need medication to abort an episode

Many people with SVT, often have short episodes of flullering in the chest. These are often called atrial premature beats.These atrial premature rates are not harmful except they cause annoying symptoms called palpitation. They can also trigger anxiety or panic attack.

In some cases, this can be related to excessive caffeine consumption.( like coffee, tea, coke, Pepsi, etc.), alcohol consumption, excessive chocolate consumption. Some people are very sensitive to even small amount of these substances which can cause atrial premature beats. And SVT.

Sometimes, atrial premature beats, can trigger SVT or another condition called atrial fibrillation during which time heart beats fast and irregular, and may produce the same symptoms like SVT.

The problem with SVT is this-Since they often occur sporadically, it can be difficult to diagnose unless an electrocardiogram is taken during an episode. Nowadays, it is possible to record these episodes at home if you have a smart watch. An electric cardiogram done in doctors office can be normal.

However, on occasions in certain individuals, resting electrocardiogram may show abnormality suggesting short-circuiting in the electrical conduction system or otherwise called ORE-EXCIETATION ( like WPW SYNDROME). If this is present, it may be the trigger for SVT or Atrial Fibrillation .

Often, your cardiologist has to do long-term monitoring called event monitoring or loop monitoring for up to a month. You press a button to activate the recording whenever you notice your heart racing

A more convenient option, which may be available is a single waterproof patch that resembles a large Band-Aid. This is placed on your chest, it can record your heart activity for up to 30 days. For less frequent episodes another option is an implantable loop recorder, which is placed by a cardiologist just under the skin of the chest.

It can be programmed to capture high heart rates, or you can activate recordings by pressing a button on a small wand held over the device. However, this is usually reserved for people with more serious symptoms, such as fainting.

PREVENTING EPISODES OF SVT

-Avoid excessive caffeine consumption and alcohol consumption.

Chocolate can also precipitate in episode and better to avoid these,if you have palpitation -Your cardiologist may recommend certain medication to prevent recurrence of these episodes -Avoid smoking, including vaping and avoid illicit drug use -Doing Yoga and Meditation is a great way to help anxiety and panic attacks and may also improve your palpitation.

WHAT CAN YOU DO DURING AN EPISODE? ⁃ Try to be calm, take deep breaths slowly. ⁃ Valsalva maneuver- This maneuver will activate the vagus nerve which will slow down the heart rate. If you activate vagus nerve, you may be able to abort an episode. During this maneuver, you take a deep breath and hold it and push down as though you are constipated and moving the bowels.

Hold your breath for about 10 seconds and then relax. If this does not abort the episode, you can repeat this once or twice one minute apart ⁃ You can also activate Vegus nerve by putting cold water on your face or drinking cold water or coughing violently few times ⁃ Carotid Sinus massage- This also will activate the Vegus nerve.

I would not recommend that you do this at home, unless you were trained to do that. THIS IS RESERVED ONLY FOR DOCTORS AND EXPERIENCED PEOPLE PREFERABLY DONE IN MONITORED SETTING. ⁃ If an episode last more than 15 to 20 minut and if you have chest pain, shortness of breath, or if you faint, someone needs to call 911 and you need to go to the emergency room

Keshava Aithal

Dr Keshava Aithal ಅಂಕ 8 Double 0