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Scared of getting a heart attack with family history of heart disease

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I am a 40 year old male. Two months ago I had a funny feeling in my chest. I sometimes suffer from panic attacks and GERD, but I drove myself to the ER just to be sure one of those was the culprit. I was kept from 4pm until noon the following day because I have a history of heart disease in my father and my paternal grandmother. X-rays, blood work and multiple EKGs all came back clear, with the exception of a right branch bundle block. The morning of my stay I was given a nuclear and treadmill stress test, which I passed. I was cleared and yesterday (2 months later) I went to my PCP for my annual physical. All tests came back fine, except for a Vitamin D deficiency. I am still having anxiety over this issue and havent been running in over 3 weeks. Today I decided to get back on the road and just walk for a bit. I logged 3 miles, but about 2 miles into the walk I had a few heart "flutters" and then was extremely anxious for the remainder of the walk. What causes these heart feelings in my throat? Allergy medicine, anxiety, GERD? How can I convince myself that if the cardiologist says nothing is wrong with my hear then Im not likely to fall over with a heart attack when exercising?


Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello

Thank you for your query at DoctorSpring.com

It’s good to know that all your tests normal. Let me reassure you that from Cardiology point of view, everything looks alright. The nuclear cardiology test has a very good sensitivity and specificity leading to a good overall accuracy. If you have ECG normal during the chest pain plus you have a normal stress thallium nuclear scan means that for all practical purposes there is a very very low almost non-existent chance that you have any coronary problems. In Cardiology practice, especially in Acute coronary situations we don’t leave much to chance.

You can exercise 2 to 3 miles. That is also very reassuring. You have been thoroughly evaluated and everything looks alright. Apart from Panic attacks, I suspect you are having generalised anxiety disorder. (GAD). It is this panic / anxiety acting up. When you are anxious or panic you tend to feel more heart related symptoms because of the adrenaline and vagal stimulation.
I recommend relocating activities, meditation or something of that sort. Do not hesitate in getting professional help from Psychiatrist too. Anti-anxiety medications can bring in good relief.

Do not try to 'convicne' or make believe. Instead address the anixety part and the symptoms will go away.
Hope this helps
Please feel free to ask followup questions.


Thank you
Regards
Dr Vivek Mahajan
DM Cardiology


Patient replied :

Thank you for the reassurance. Is it possible that yesterday's "heart fluttering" while exercising is related to allergy medicine or the acid reflux too? Is there anything I should do when I feel that feeling (almost like double beats rather than skipping a beat, or even more accurately described as a gas bubble).


Expert:  Dr. Vivek Mahajan replied 3 Days.

Hello,

Thanks for your reply.
You could measure your pulses rate for any irregularities during such an episode. I dont think any allergy or drugs could lead to such a symptom.

Occasionally an extra beat can occur during exercises but that is often felt of as a missed beat. Measure the heart rate or pulse rate during these episodes and if they last long enough get to a ECG lab and get an ECG. But I think it is something that your mind is scared of and that is producing these symptoms.

Regards
Dr Vivek Mahajan
DM Cardiology


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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