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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Intermittent Episodes Of Tremors, Increased Heart Rate, Breathing Trouble, Stabbing Heart Pain. Panic Attacks?

Every once in a while I will get uncontrollably shaky and my heart rate is already naturally over 100 but it beats faster at certain moments. Sometimes there will be moments where it hurts to breath and there is a stabbing pain on the side where my heart is. I have gone to a doctor but they say it is just a panic attack. My problem with them summing it up to being that is that these symptoms will only occur randomly. I could be feeling great with no worries, I could be completely stressed out. It never has a connection. I am currently at work and I can t seem to calm down, I keep shaking and my heart is beating a little bit faster. What is wrong? Doctors keep summing it up to anxiety or panic attacks. Is that true?
Mon, 22 Oct 2012
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Cardiologist 's  Response
Hi
Anxiety is likely but not the only cause. There could be several reasons - it sometimes happens normally also! Anxiety may not be the case with you - random and no relation, as you say.
It may be Mitral Valve Prolapse , anomalous pathways and so on.
Proper treatment needs proper diagnosis. First thing to do will be to see a cardiologist and get examined - especially during one such episode. In this situation, we start with routine ECG, ECHOcardiogram, blood tests (cell count, sugar, thyroid). If there is no clue, we go further - 24 to 48 hour ambulatory ECG monitoring (Holter).
Your doctor will decide on the need for medications - beta blockers for example can help in both anxiety and palpitation
Wishing you a speedy recovery
Good luck
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Psychiatrist Dr. Jonas Sundarakumar's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

Your symptoms indeed seem to be indicative of a panic disorder, which is a type of anxiety disorder. Typically, panic attacks occur 'out-of-the-blue' and don't have to be associated with any stress or worry. It is caused by certain neuro-chemical imbalances in the brain. There are very good treatment options available - such as medication and psychotherapy. Please consult a psychiatrist for a detailed assessment and further treatment.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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General & Family Physician Dr. Kulbir Singh's  Response
Hello Paul and thanks for the query
50% of the case has increased heart rate due to panic attacks. Other 50% are due to problem in conduction symptoms of heart i.e AF or PSVT. These episode occur randomly, whatever situation is while in stress, walking, siting, sleeping etc. To rule out this do your EKG at the time of episode or go for holter study and show it to your cardiologist. Your cardiologist can guide you better.
Best Wishes
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Intermittent Episodes Of Tremors, Increased Heart Rate, Breathing Trouble, Stabbing Heart Pain. Panic Attacks?

Hi Anxiety is likely but not the only cause. There could be several reasons - it sometimes happens normally also! Anxiety may not be the case with you - random and no relation, as you say. It may be Mitral Valve Prolapse , anomalous pathways and so on. Proper treatment needs proper diagnosis. First thing to do will be to see a cardiologist and get examined - especially during one such episode. In this situation, we start with routine ECG, ECHOcardiogram, blood tests (cell count, sugar, thyroid). If there is no clue, we go further - 24 to 48 hour ambulatory ECG monitoring (Holter). Your doctor will decide on the need for medications - beta blockers for example can help in both anxiety and palpitation Wishing you a speedy recovery Good luck