Advice please...

[Willyman]

Just a couple questions...

Back in January, I started having what I believe to have panic attacks. I have visited the ER twice, my doctor once, and a cardiologist once. I had ECG's and bloodwork done both times I went to the ER, and all tests came back normal. The cardiologist fitted me with a heart monitor, that I wore for a month to record my heart rhythms when I had symptoms or an attack. Of course, nothing out of the ordinary was found. So after all of this trouble, I basically gave up and tried to admit to myself it was anxiety and would pass.

Ever since this started I've had some health anxiety over it and began to notice things that my heart does. I noticed that I could see my heart beat at the base of my neck, where the collarbones meet. This I'm supposing is completely normal, but I thought it was odd I never noticed it before. Also, sometimes when I get out of a chair or run up steps, my heart starts to thump hard enough for me to feel it in my chest and throat. I haven't had any attacks since the beginning of February and I keep telling myself that I'm fine. Truth be told, I generally won't ever see a doctor unless I'm extremely ill.

So my question is, Should I go to the doctor to get more tests done, like a stress test, etc. or are the tests that have been run already enough to rule any problems out?

Thanks for your time and apologies for the many details! -Will

[RLR]

Noticing a carotid pulse is not uncommon, particularly in cases where athe phenomenon known as pounding heart is present and is entirely benign in this case. Rising from a chair or from a lying position always invloves orthostasis, or the body's compensation for changes in blood pressure necessary to maintain perfusion and is a normal physiological process. Negotiating stairs or other similar exertion will always produce an increase in cardiac force as a compensatory response.

Your tests indicate no pathology. If you are above the age of 40, then it's always a good idea to undergo a treadmill or chemical stress test, together with a general cardiovascular screening, if you have both personal and family risk factors.

Otherwise, it sounds as if you've allowed your worries to initiate some vigilence toward your physiology. Many autonomic processes go unnoticed until health anxiety is present, which subsequently gives rise to unfamiliar occurances that are misconstrued as possible warning signs.

You'll be fine.