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Heart palpitations represent a subjective experience of irregular heart rhythm, which is also called arrhythmia. There are several different types of arrhythmia, depending on the region of the heart muscle which produces irregular impulses. Anxiety issues, especially panic attacks, have long been considered related to the development of heart arrhythmias. However, there is still a debate among scientists about the causative relationship between these two issues. Here we discuss some of the most important features of this complicated relationship.

What Is Anxiety?

First of all, the term anxiety is very often used to describe a feeling of uneasiness or discomfort in specific situations. However, this is in most cases an exaggerated term. In other words, not everyone who gets a little nervous has anxiety issues. Only persons who are prevented from performing daily activities due to anxiety can fall under this category.

Anxiety is a large group of neurotic disorders which ranges from social anxiety and panic attacks to severe phobias. For every type of anxiety, there are established diagnostic criteria and only a trained psychiatrist can make such diagnosis.

How Anxiety Affects Heart Function

In some forms of anxiety, such as panic attacks, persons also have some somatic symptoms, besides pure psychological issues. One of the most common complaints is an elevated heart rate. The mechanism by which such attacks affect heart function is the same as that present in fear, anger, or intense physical activity. In these situations, the sympathetic nervous system is activated, which produces so called “fight-or-flight” response. The manifestations include dilated pupils, deep breathing, increased blood flow through the muscles, and elevated heart rate. Normally, when the real reason for such reaction exists, these manifestations only last until the danger is eliminated. On the other hand, in persons with anxiety, the symptoms can persist for a longer period of time, which can cause an irregular heart rhythm.

Panic attacks and heart palpitations make up something like a vicious circle, as the affected person gets oversensitive and persistently afraid in expectation of the new palpitation.

Causative Relationship Between Anxiety And Heart Palpitations

Scientists are still debating what occurs first – anxiety or heart palpitation issues. There are good bases for both scenarios. Anxiety can stimulate a person to focus too much on bodily issues, especially those which cannot be consciously controlled, among which is heart rhythm. On the other hand, frequent palpitations can produce psychological issues leading towards either depression or anxiety. More randomized studies are certainly required in order to develop the correct conclusion.

Possible Treatment Options

In all persons complaining of heart palpitations, an ECG record is required. In some cases, your doctor may recommend a 24-hour Holter-ECG recording in order to track your heart rhythm for 24 hours. Different types of antiarrhythmic drugs are available for different types of arrhythmias. If heart rhythm disorders turn out to be related to stressful situations, psychiatric examination is also required.

Anxiety issues are most commonly treated with a combination of antidepressants, such as Xanax and benzodiazepine anxiolytics, like clonazepam. Sometimes, cognitive behavioral therapy is also necessary.

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