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Panic Attacks and Heart Palpitations


A heart palpitation can be a frightening experience, especially when caused by a panic attack. While heart palpitations are generally not dangerous, they can signal a more urgent problem.

What is a panic attack?

A panic attack is a sudden occurrence of intense fear without apparent danger or reason.

A panic attack sets off a series of severe physical reactions:

  • Sense of impending danger, or doom
  • Rapid, pounding heart rate
  • Nausea
  • Hot flashes
  • Headache
  • Chest pain
  • Shaking, or trembling
  • Shortness of breath, or throat tightness
  • Gastrointestinal discomfort
  • Tense muscles

During these attacks, you may feel like you are having a heart attack, or even dying.

Panic attacks are not dangerous, but they can mimic symptoms of a more dangerous condition, such as heart attacks.

Call your doctor if you are unsure what is causing your panic attacks.

What are heart palpitations?

Heart palpitations occur when the heart skips a beat, adds one, or the rhythm becomes irregular. Your heart may feel as if it is racing, jumping out of your chest, flipping, or fluttering. You may feel these sensations in your chest, or throat.

Most of the time, heart palpitations are not harmful, and will go away within a few seconds; however, call your doctor if they last more than several seconds, become uncomfortable, increase in frequency, or are accompanied with chest pain, difficulty breathing, dizziness, or fainting.

Many different factors can cause heart palpitations:

  • Heart Arrhythmias
  • Certain medications
  • Caffeine, or other stimulants
  • Abnormal electrolyte levels
  • Hormonal changes, such as during pregnancy, or menopause
  • Low thyroid levels
  • Low blood pressure
  • Low blood sugar
  • Fever
  • Dehydration
  • Anxiety

Can a panic attack cause heart palpitation?

Anxiety and panic attacks activate your autonomic nervous system (ANS), which controls your breathing, digestion, muscles, and heart rate. If presented with stressful or fearful circumstances, your ANS sets off your body's "fight or flight" response. Your heart and respiratory rate increase to provide more oxygen and pump more blood to prepare your body to fight, or flee from whatever is causing the stress, which can sometimes set off heart palpitations.

Aside from problems with your heart, anxiety is the most common cause of heart palpitations.

Heart palpitations from anxiety, or panic attacks, usually come on quickly, and subside just as quickly, usually within a few minutes. If they do not go away during that time frame, the frequency increases, or you experience these sensations without a proceeding feeling of panic, discuss these symptoms with your doctor, since they may be something other than panic attacks.

Are heart palpitations dangerous?

Heart palpitations caused by anxiety are not necessarily dangerous. They will usually stop once the anxiety, or panic attack goes away.

Heart palpitations, however, can signal a more serious heart problem, such as arrhythmia. Heart palpitations caused by a heart arrhythmia will usually cause a feeling of anxiety, not follow it.

Arrhythmias may be a sign of a heart problem.

When should I call my doctor?

Call your doctor if your heart palpitations increase in frequency, last longer than a few minutes at a time, or change in characteristics.

Call 9-1-1 if your palpitations come with chest pain, shortness of breath, dizziness, or loss of consciousness.

You should also tell your doctor if you have anxiety, your panic attacks increase in frequency, or last for extended periods.

Diagnosis

Your doctor will ask you about your medical history; stress level; diet: medications: supplements, and lifestyle. They will then probably draw blood to check for other problems, such as anemia, low potassium, or a thyroid problem, among other possibilities.

To rule out a more urgent problem, your doctor may order a chest x-ray, Electrocardiogram (ECG) of your heart, echocardiogram, or an exercise stress test. You may also need to wear a home heart monitor for a few days, to determine what your heart is doing over long periods.

Treatment

Your doctor may prescribe antidepressants, or medication to control your anxiety if that is determined to cause your heart palpitations. They may also recommend psychotherapy, or complementary treatment, such as massage therapy or biofeedback.

Self-management techniques for panic attacks:

  • Being mindful of your triggers
  • Getting regular exercise
  • Eating a healthy, balanced diet
  • Getting enough sleep
  • Managing stress
  • Do deep breathing exercises
  • Yoga, or another form of mindful movement
  • Meditation
  • Relaxations techniques

Talk to your doctor if you think your heart palpitations might not be from anxiety or panic attacks, or if they come with chest pain; shortness of breath; dizziness; fainting; severe swelling, or fatigue.

Key take-aways

Panic attacks can lead to heart palpitations. Usually, these palpitations will go away as the panic attack subsides. They are generally not dangerous, but if they start to happen without association with panic attacks.

If panic attacks become uncomfortable, or you have difficulty breathing, talk to your doctor. These symptoms could be indications of a more severe problem.

You should also talk to your doctor about your panic attacks if they become more frequent, or last for longer periods. Your doctor can help you find a treatment that can calm your anxiety and possibly reduce heart palpitations.

Sources:

Ansorge, Rick. (2021). Heart Palpitations. Heart Palpitations: Causes, Treatments, After Eating, Lying Down (webmd.com)

Cleveland Clinic. (2021). Heart Palpitations and Anxiety: Causes, Symptoms, and Treatment. Heart Palpitations & Anxiety: Causes, Symptoms & Treatment (clevelandclinic.org)

Mayo Clinic. (2022). Panic Attacks and Panic Disorder. Panic attacks and panic disorder - Symptoms and causes - Mayo Clinic

Roland, James. (2019). Heart Palpitations and Anxiety: Causes, Symptoms, and Treatments. Heart Palpitations and Anxiety: Causes, Symptoms, and Treatments (healthline.com)

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