Suggest Treatment For Premature Ventricular Contractions In A Person With Anxiety

Posted on Mon, 20 Apr 2015

Question: Hi Doctor I suffer from extreme anxiety and I have been doing CBT therapy for 1 month. I was diagnosed with pacs and rare pvcs. For the past few months my palpitations have been better. The last 2 nights they have started again. I had a full heart work up 2 months ago and cardiologist says my echocardiogram and stress test show a structurally normal heart. My question is can anxiety really cause all these etopic beats and palpitations?

Answered by Dr. Ravi Soni (51 minutes later)

Brief Answer:
Yeah, anxiety can cause these

Detailed Answer:
Hi, thanks for writing through HCM.

I have read your query and understood your concerns.

Our body is prepared to fight or flight in fearful and danger situation. This is body's defence mechanism. In anxiety, the body has false alarm regarding any dangered situation and this system is activated by fault. When a person has fight or flight reaction, there is secretion of adrenaline which makes heart beat faster, which ultimately results in palpitations and other anxiety symptoms.

Other cause is hyperventilation, in which body is washed out of CO2 and in an attempt to push blood harder, heart has to beat faster, which causes palpitations and ectopic beats.

So, yeah anxiety can cause ectopic beats and palpitations.

Even in a person with heart disease or arrythmia, doctor usually prescribe a anxiolytic because anxiety can cause heart beat faster, which may ultimately result in dangerous situations.

Hope I have answered your query. If you have further query then I shall be happy to help.
Wish you good health.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ravi Soni (15 minutes later)

Hi Doctor Thank you for your response. I had my heart checked and everything seemed ok just these Pacs. So if they are due to anxiety they are benign? Are these dangerous to my health?

Answered by Dr. Ravi Soni (10 hours later)

Brief Answer:
They are harmless

Detailed Answer:
Hi, thanks for writing again.

These palpitations and PACS are benign and not harmful.

Actually the treatment of these is to treat the anxiety. That can be accomplished by antidepressant drugs like SSRI which controls the anxiety at neurochemical level in brain and controls the false alarm of fight and flight reaction. It is good that you are going for CBT but if the anxiety is out of control then you need to take drugs. Drugs along with CBT will give best results.

In my patients, I would have started lexapro 10 mg at night. It will show benefit after 15 days only. The drug need to be continues for at least 6 to 8 months with regular follow ups to psychiatrist. CBT is also beneficial which allows psychiatrist to decrease the dose rapidly and to make the patient drug free earlier.

Cardiologist is telling you the right thing, these palpitations are harmless.

Discuss all these issues with a psychiatrist and follow his advice.

Hope I have answered your query. If you do not have further clarifications then close the discussion and rate the answer.
Wish you good health.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Pradeep Vitta