ER visits, Anxiety and Cardiac Issues


Me: So, you are coming in for hospital follow up after an Emergency Room visit for chest pain? We last saw you in the office back in May. What happened?

Patient: Well actually I went to ER a few times since May.

Me: How many is a few times?

Patient: 9 times

Me: Really?! Is everything alright?

Patient: I go too often, I know, I have to visit ERs further from my home because I know the ER staff near me is tired of me. All the tests say I am fine but I just cannot convince my mind.


Anxiety and Cardiac Issues

Peanut butter and jelly, macaroni and cheese, spaghetti and meatballs. All these things have one thing in common (no, not deliciousness)…they all go well together. Just like anxiety and the heart issues. They are closely related, like first cousins.

An old, wise ER doctor once told me “many people having an anxiety attack are certain it is a heart attack and many people having heart attacks are certain it is an anxiety attack”. So similiar are the symptoms of myocardial infarction (heart attack) and anxiety (panic) attacks that the Anxiety and Depression Association of America (ADAA) as an article on the webite entitled Am I having a panic attack or a heart attack? which can be found here.

The effect of anxiety on the heart

When someone is anxious, their body reacts in ways that can put an extra strain on their heart. The physical symptoms of anxiety can be especially damaging among individuals with existing cardiac disease.

Anxiety may have an association with the following heart disorders and cardiac risk factors:

  • Rapid heart rate (tachycardia) – In serious cases, can interfere with normal heart function and increase the risk of sudden cardiac arrest.
  • Increased blood pressure – If chronic, can lead to coronary disease, weakening of the heart muscle, and heart failure.
  • Decreased heart rate variability – May result in higher incidence of death after an acute heart attack

-Dr. Una McCann, Johns Hopkins University

So what can be done about anxiety and heart issues? First, seek medical treatment. Most physicians like to rule out cardiac issues first. Then see a licensed mental health practitioner. Especially someone who specializes in anxiety disorders.

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