Heart related anxiety/panic attacks [Archive]

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Urke

25-07-15, 14:48

Hi all,
I am 26 year old guy, over recommended weight but its mostly not fat since I lift weights and exercise for 10 years. I am kind of a nervous/grumpy dude, I tend to overanalyze things but never had a panic attack or unexplainable anxiety. I tend to have higher blood pressure, especially when measured at doctors (it got to 180/90 once).

About two months ago I got a strange pattack after drinking green tea and taking a caffeine pill. I felt like I was going to die of a heart attck- short of breath, weird unreality, feeling heartbeat, panic. I calmed down, and nothing happened for about a week. Meanwhile I took psilocybin mushrooms for the first time in my life(I know, stupid) and had a kind of bad trip with some panic, but I calmed down while still on them.

Then it started happening more often, and I became anxious about it even when I wasn't panicking. For as long as I remember, I used to get some kind of random chest stabs, and used to forget about them, but now they trigger a full blown panic.

Then I figured out that most of my family from my mom's side had similar experience at some point in their lives, and were reassured by doctors they are fine. None of the closer relatives had any heart problems except those that high BP when they got older.

So I went directly to the cardiologist, did a blood test, ECG, Echo, Stress test, and 24h blood pressure monitor.
Doc said my heart was fine (left ventricle is enlarged but within normal range, he said its because I am active) but gave me blood pressure meds which brought down my BP from 140/80 to about 120/70. My resting pulse has always been around 55 bpm. He said I should lose 20 pounds, avoid salt, and keep up with my usual exercise routine but emphasize cardio.

The problem is that I still have anxiety, though it got better and I don't constantly worry about it. It is worse when I exercise, it got to the point where I have to take a bromazepam as a pre-workout...
It is worst after I try to go heavy on the weights. After I finish a set I feel intense panic and strong heartbeat. It never used to be a problem, and now it happens even on weights that are 70% of what I used to lift.

I used to love to go to the gym, but now I dread every workout... The worst thing is that I read on the web that those symptoms after exercise are related to angina and heart attacks... But would those tests that I did rule them out?

Frenchy

25-07-15, 18:13

Hi Urke

Firstly, it's important to understand that a Heart Attacks and Angina are specifically caused when the arteries leading in to your heart become blocked by fatty deposits and arterial plaque - caused by factors such as high cholesterol, poor diet, smoking, family history etc.

The good news for you is - it is extremely rare (as in, almost unheard of) for this to occur in someone in their 20's. Even with the worst diet AND a family history of heart disease, that is simply not old enough or long enough to have had sufficient build up in your arteries to cause angina or heart attack. Secondly, yes, the exercise stress test would have picked angina up if the improbably had happened and a 20-something had this.

I'm intrigued about the bromazepam taken as a pre-workout. As a benzo, there will a number of potential issues taking that before exercise. As a muscle relaxant that is normally intended to bring on a mild sedative effect and some drowsiness, I'd imagine that would conflict quite a lot with you putting your body through intensive activities like cardio or weights. Have you asked your GP if this is ok? If you haven't, then I would if I were you. I'm sure you are aware of the risks associated with long term benzo usage (including tolerance build up and dependency).

Have you considered any therapy or therapeutic techniques like CBT in order to manage and address your anxiety?

Your doctor's advice to avoid salt, lose a bit of weight and exercise is good. Do also make sure you stay hydrated and maybe consider a few heart-health supplements to your diet, like oily fish (or take a high strength omega 3 supplement) and look into adding some high potassium foods too - bananas for example, or a glass of coconut water after your workouts would be great. These things are excellent for general heart health. Also, get a cholesterol test now and see what it is. If it's high, now is a great time to make small adjustments that will have big benefits as you get older!

Yeah... and no more mushrooms :winks:

Urke

26-07-15, 20:08

Frenchy

26-07-15, 22:02

Thank you for reassurance and advice!

While I am aware that heart disease among young people is rare, a friend's relative who was an athlete died at very young age, his heart apparently stopped for no reason, and I can't stop thinking about cases like that when I go into panic...

The blood test said that my bad cholesterol is actually elevated (mine is 4 where recommended upper limit is 3.4) That added to my fear that my arteries are already clogged...

I am going to follow your advice on omega 3 supplement and bananas (which I used to eat a lot more, not sure why I stopped). I am also taking spoonful of coconut oil every day.

I am not sure if there is such thing as CBT where I live. Do private psychologists do that?

Hi again. I think that what your friend probably went through was a sudden cardiac arrest - which is not the same as a heart attack and is not caused by blocked arteries. Also, to be clear, it didn't stop for no reason. It stopped because there was a defect there. Hearts simply don't stop for no reason. It may be that the reason was not determined (and sometimes the cause simply can't be determined post-mortem) but there would have been a cause and it probably would have been identified had he gone through the kind of cardiac screening that you have had recently.

As I said, I'm certain that as you are in your twenties, your arteries will not be blocked. Guidelines may vary by country but in the UK the guidelines until recently were 5 or below for cholesterol. They have recently changed I believe to 4 or below. But in either case, 4 is actually pretty good. Do you know what the breakdown of LDL/HDL is? HDL is the good cholesterol and LDL is the "bad".

So forget about blocked arteries for now. That is extremely unlikely to be a concern for you at 26. If it is a sudden cardiac arrest that you are worried about then indicators for the kinds of defects that could potentially cause that would have come up in your recent cardiac tests.

I would imagine that CBT is pretty globally available these days- although I can't be certain... it's a actually a good question... maybe someone will be along to answer that one better than I can.

Urke

27-07-15, 08:18

Frenchy

27-07-15, 10:15

Actually my breakdown is
(mmol/L)
Total cholesterol - 6.28
HDL - 1.88
LDL - 4.03

I already took measures to reduce it since I tested it about a month and a half ago, mainly by reducing intake of egg yolks and fatty meats.

OK, so that is too high but now that you know, you can bring this down.

To give you some context, mine is about the same as yours @ around 6.

Now I'm 37 (11 years older than you), I have been slightly overweight most of my adult life, not really in to exercise and a 20-a-day smoker up until this year (now quit). I have a family history of heart disease (grandfather, father and uncle). I had an angiogram 2 months ago that showed completely clear and clean arteries - just to give you some idea about how long build up can actually take to form, even with pretty high cholesterol. Now my cardiologist was not surprised my arteries were clear. Despite my family history, smoking and higher cholesterol my cardiologist explained to me that it would still be extremely unusual for someone in their 30's to have clogged arteries. So imagine what he would say to someone in their 20's. I'll tell you what he'd say - he'd say it was virtually unheard of!

Take all this as a blessing. You have been told things are fine, you have been given some good advice in terms of your general heart health and you have learned that your cholesterol needs to come down to ensure you stay healthy as you get older. These are all good positive things! Most people in their 20's and 30's actually don't bother to get their cholesterol checked - and then years later it's too late. But not for you! :)

Urke

27-07-15, 10:59

Frenchy, your words are really helpful, thanks a lot :)
Good job quitting smoking!

This experience really is a kick in the butt to move towards healthier lifestyle.

I guess we all are too well informed about heart disease symptoms by all the media, and those of us more prone to anxiety tend to associate unrelated things with the heart because it is what we are most scared of.

iwantpeace

09-08-15, 18:14

well 140/90 its not that much and you sertenly dont die from it.
blood pressure should always be taken when you are at rest.
if you are like full anxious it will show more like 160/100.

if you change your diet and loose some weight your blood pressure will
go back to normal and you wont even need meds.
if you smoke, stop it!