Anxiety is on the rise, with more of us feeling anxious more often than in previous years. But what if those feelings aren't actually anxiety, but rather a symptom of a potentially serious cardiac issue?
Fast or erratic heartbeats are the hallmark of arrhythmias like supraventricular tachycardia (SVT) and atrial fibrillation (AFib) — an irregular heart rhythm in the upper chambers of the heart (the atria). Because the symptoms overlap so closely, both SVT and AFib are frequently dismissed as anxiety or a panic attack.
“It’s often very difficult for the lay person to tease out the difference between anxiety and a real heart rhythm problem,” said Endeavor Health cardiac electrophysiology expert Sahil Attawala, MD.
“Diagnosis requires evaluation and monitoring by a cardiac specialist. The key to diagnosing AFib is to capture an event during an EKG (electrocardiogram),” he said.
Symptoms in common
There’s definitely an overlap in some of the most common symptoms of anxiety and heart rhythm issues, including:
- Feeling like your heart is racing
- Palpitations, or awareness that your heart is beating fast
- Dizziness or feeling lightheaded
- Hyperventilating and/or shortness of breath
Any of these issues can be reason to check with a physician.
“We’ve seen patients who have been experiencing symptoms most of their adult life,” said Dr. Attawala. “Sometimes an initial evaluation doesn’t reveal anything. When episodes are infrequent it can be difficult to capture it as it happens and an EKG can be normal.”
“Everyone feels AFib differently and some people don’t feel it all,” said Dr. Attawala.
How doctors tell the difference
When cardiac specialists look at EKGs, they are looking at both the heart rate and the heart rhythm, explained Dr. Attawala.
In a person experiencing high anxiety, their heart rate may be faster, but their heart rhythm is normal. When both the heart rate and rhythm are abnormal, it suggests a cardiac issue.
Patients are often sent home with a heart monitor that helps physicians track patterns over time.
Many people with wearable fitness devices and trackers, including Apple watches, are becoming more proactive and seeking evaluation when a cardiac irregularity is flagged by their own device, added Dr. Attawala.
Be your own advocate
There are people who have been told that their symptoms are a manifestation of their anxiety, by a professional or even a well-meaning family member or friend.
“You have to be your own best advocate. If you think you’re not really anxious and are experiencing episodes multiple times a month — even when you feel relaxed — it’s definitely time to get checked out,” urged Dr. Attawala.
AFib is not immediately life-threatening, but if left untreated it can lead to higher risks for stroke and heart failure, explained Dr. Attawala.
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