RLR
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Hi Carol,
Let me preface my response to you question with some information that may be helpful. Because of the nature of the forum and certain legal provisions, I'm unable to specifically address decisions about whether you should see your primary care doctor or specialist. I had explained this to several other forum members and I hope you understand that when such questions are directly posed, I simply can't provide guidance in that regard. The reason is sort of a one-way issue and I'll be glad to explain it here.
If someone visits the forum and describes symptoms to me which have not been evaluated by their doctor that I recognize could potentially place them at risk if not evaluated promptly, I will suggest that they be seen by a licensed physician and waste no time in saying so. Symptoms not previously evaluated that do not represent imminent risk are freely discussed and the option to seek medical treatment is elective. If, by contrast, a person who has been previously evaluated by their doctor describes symptoms relevant to that examination asks if I think they should return to their doctor, it places the matter in an entirely different light. The easy way out would be for me to simply say "yes" in all cases, except that many people who suffer from the conditions being discussed on this forum merely need a good deal of reassurance. My professional opinion could constantly sway people to return time and again to their doctor and consequently cost them a good deal of money, not to mention increasing frustration on the part of their healthcare providers. If I expicitly say "no" to the question, then I'm ignoring the fact that I have not directly evaluated or examined the person and therefore, violating professional ethics at the very least. Does that make sense?
So I'll be glad to discuss any of your symptoms, but when the magic question appears in the forum, I can only give one response.
Alright, let's get to the matter then. The characterization of benign palpitations can often change depending upon factors related to stress and anxiety. Naturally, it doesn't help matters much that the source of increasing tension and worry rests with the symptoms themselves. It's important for people suffering this type of syndrome to understand that from a medical standpoint, true heart disease takes years rather than a few months to develop. Additionally, heart disease that is of sufficient consequence to cause dangerous arrhythmias to appear have already induced other symptoms known to the patient that may or may not have been reported. Disruptions to normal sinus rhythm of the heart in of itself does not constitute a warning sign of heart disease. Care must be taken not to generalize or stereotype aspects of medical science in the same manner that many other occurrences in life are perceived.
Most patients, when faced with this type of dilemma, have the following general perception; If a patient feels that they posess some risk factors for heart disease, then in the presence of palpitations, they feel compelled to constantly be vigilent for signs of change in order to prevent a tragic event. They are unable to relax because they trust more in their belief system than they do medical science and factors of known probability. Since most people have no formal medical training or daily exposure to conditions like heart disease, they have no abililty to understand their symptoms based on such logic, but rather only what they've read, heard about, or observed in the media or by personal association with someone known to them as having had heart disease. For instance, when reading or hearing about a person suffering a fatal arrhythmia, their mind begins to make comparisons based upon subjective criteria, such as what the affected person described or felt or experienced during the event. If key words are used such as dizziness, coughing, radiating pain, sweating, or other descriptor, then it immediately draws closer the comparison for the person worried that a direct correlation exists with regard to their own symptoms. In truth, all of the descriptors mentioned in the case of a true dangerous arrythmia are occurring for specific reasons having to do with heart disease. So what I'm saying to you here is that symptoms of dizziness, pain, sweating or palpitations are not universal by any means whatsoever. They absolutely do not mean the same thing in all instances. This is a fact that members to the forum must realize. As physicians, we see countless variations of these symptoms and many others not mentioned here, that present themselves with far more peculiarity in the instance of different disorders, syndromes or diseases than the average lay person might think.
So the take home message here is that a person afflicted with anxiety disorder must begin to evaluate whether their perceptions and manner of logic or patterns of thought are accurate in all cases or possibly flawed, but nevertheless being relied upon by virtue of habit and "gut feeling" about the matter. There is always some degree of compulsion with anxiety disorder that if translated to mere thought would sound something like "Yeah, but what if?????" There is an insatiable urge to check and re-check, despite logic to the contrary. It is an urge incredibly resistant to self-scrutiny because its absence only intensifies anxiety and need to act upon its influence.
I hope this helps.
Best regards and Good Health
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