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Heart Palpitations Forum >> Symptoms and other concerns >> Newcomer- question for RLR
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Message started by e_ramon on May 15^th, 2010, 2:24pm

Title: Newcomer- question for RLR
Post by e_ramon on May 15^th, 2010, 2:24pm

Hello everyone, been browsing this forum for a while and I'm immensely grateful to have found it. I have a question to direct towards RLR, although any answers would be appreciated.

I experienced my first panic attack about 3 years ago when I was 18, at which time I had started smoking cannabis. I completely freaked out one evening during a smoking session with my friend- just an enormous, full-on panic attack, while stoned. NOT good.

Since then I've mostly come to terms with what happened, and completely cut out smoking in all forms. There's just one particular memory that sticks with me, because I've never really seeked out a qualified opinion on it. A few hours into my panic episode, I was trying to relax on the couch when I felt my pulse slow way, way down, seemingly about to stop, and I began to black out. My body then reacted with the most immense nervous jolt imaginable and my heart started RACING within seconds, up to the kind of rate I'd normally associate with sprinting. This happened several times and I literally thought I was on the edge of dying.

I have no family history of heart disease- in fact both my parents I would say are fairly athletic- and I do have some family history of anxiety in various forms. I enjoy exercising, I've even run a 10km race before- and I have NEVER fainted in my life (that was the only time I've even come close). I've had 2 ECGs recently which were both completely clear of anything suspicious. But would you be able to explain to me what it was I experienced? I really feel like I should know.

Thank you very much RLR, for your time and for your wisdom- it is most appreciated.

-Edward

Title: Re: Newcomer- question for RLR
Post by RLR on May 15^th, 2010, 7:18pm

Hi Edward and welcome to the forum. The episode you describe is due to a vasovagal response and is very common among persons experiencing a panic threshold. The vagus nerve is responsible for maintaining tone to the extent that blood pressure is held within a specific range as the forces of gravity act upon the body. In order for this to occur, there must be a constant level of feedback. In the absence of the requisite feedback, vagal tone is reduced, sometimes very quickly and the result is lightheadness or even syncope(fainting).

The most common example of this is soldiers who stand at attention for extended periods without movement. Vagal tone can become diminished to the degree that perfusion to the brain is mildly diminished. The consequence is fainting and falling forward. Another common example of rapid vasovagal reaction is being suddenly startled. Many people experience a sudden drop in blood pressure after being frightened and will often faint. For those that only experience a drop in pressure, the internal carotid arteries in the neck contain baroreceptors which sense changes in blood pressure to the brain and send feedback to the cardiac center in the brain. The fastest method for the body to recover from sudden hypotension is to increaxse cardiac force and rate, which is experienced as pounding heart. It is a natural physiological response.

Cannabis contains tetrahydracannabinol, or THC, which has the capacity to alter blood/brain chemistry in a manner very similar to that suffered by persons who experience panic thresholds. It is a common presentation in the emergency department.

The collective episodes that you describe would in no way be indicative of heart disease, structural abnormalities or similar pathology.

Lastly, I'm far too old to offer lectures on drug use and experimentation is a fairly common event in the lives of young people these days. I will say that in the instance of panic thresholds, a latent pattern of panic can sometime ensue because patients who have experienced it dread a recurrence that often precipitates that very consequence. In other words, panic can become formed upon the fear of recurrence in the absence of drug use.

You're just fine and there's nothing at all wrong with your heart.

Best regards and Good Health

Title: Re: Newcomer- question for RLR
Post by e_ramon on May 16^th, 2010, 2:56pm

Thank you for your prompt reply RLR, which has finally put my mind at rest. :)

With hindsight, if it was anything truly serious I would probably know by now, as it stands though I was just always curious about what actually happened. Thankfully since I stopped smoking it's never re-occurred.

Thanks again!

-Edward