Hello,

It is quite a common theme for patients with anxiety disorder to develop specific anxiety regarding their health because in most cases, the anxiety has risen to the level that physical symptoms (somatic features) are experienced. The presence of these symptoms in most all cases is mistaken for signs of physical disease and leads to multiple presentations to their primary care physician or a specialist.

Subsequently undergoing diagnostic tests and yielding negative results has an almost paradoxical effect because while patients gain temporary reassurance, they soon develop higher levels of anxiety that something has been overlooked. It often becomes a compelling expedition in search of an underlying physical cause for physical symptoms where in reality, no such connection exists at all. By virtue of common experience, people becomed trained to seek medical attention in the presence of phyical symptoms. The problem is that diagnostic equipment is designed to detect actual or true physical disease, so a negative result literally means negative. This fact does not calm the anxious patient, however, who genuinely becomes convinced that they potentially have something very serious and moreover expect that medicine should be available to cure the problem. What makes the patient return time and again is the fact that despite negative tests, the symptoms persist. To the patient, this flies in the face of common sense.

So now in answer to your question in a more specific manner, the ECG and cardiac enzyme blood work is an excellent diagnostic choice for seeking evidence of present or recent cardiac events or signs of heart disease. You have to realize that these tests detect markers that must be present if heart disease is present as well.

It's important for you to understand that with regard to anxiety disorder, physical symptoms can definitely be present in the absence of physical disease. You are experiencing symptoms associated with dysregulation of the sympathetic and parasympathetic nervous system, demonstrating a response more commonly known as fight or flight.  Simply because your symptoms are associated with the heart, does not reflect that you have something wrong with it. The heart is actually being stimulated from the vagus nerve.

I'd invite you to please refer to my postings in the general category entitled HEART PALPITATIONS 101 PARTS 1 through 6. This will give you a better understanding of what's actually taking place. Always remember that this type of stimulation will never cause you to experience a cardiac event of any kind and will never damage the heart tissues or wear them out for any reason. It's simply an inappropriate nerve impulse that is being superimposed upon the normal sinus rhythm of the heart.

As I've stated to many members and visitors to the site, what you're experiencing in a chronic fashion due to anxiety, actually occurs as a very normal feature of a response to being suddenly startled or frightened, with the exception that it's being misperceived by the affected person because it's happening outside the presence of anything overtly frightening. Does that make sense?

In other words, when you're frightened, surely you've felt the sensation of an almost absent heart beat followed by a rapid pounding heart rate. Some people when frightened feel a flushing sensation, tingling in the extremities, weakness, a sinking sensation in the gut, sweating, rapid or erratic respiration and other features normally recognized immediately following the frightening event. Some people even exclaim things like "my heart skipped a beat" or "my heart stopped" or "I could feel my heart up in my throat" or "I felt weak in the knees" or "I couldn't catch my breath" and many other descriptions of what they experienced. Do you see anything familiar about these decscriptions that are also common in people suffering from anxiety disorder with physical symptoms?

Well, as a matter of fact we're talking about the exact same thing in both instances, only in the case of the anxious person, the fear is unidentified and because it's chronic in nature rather than from a single point in time,  the affected person experiences a constant low level dysregulation of the nervous system which is sort of permanently engaged in response to a perceived threat rather than a real one. See how it works?

In other words, when you're frightened by something within an immediate time frame, the symptoms seem normal and people do not say to themselves, "my gosh, that loud bang made my heart jump. I must therefore have something wrong with my heart." They know it to be a normal response to fear, so they are unconcerned by palpitations that occur under such circumstances. But when anxiety produces constant symptoms of the same type from the very same source, the mind is unable to make a direct temporal connection between the symptoms and the long-term and unidentifiable fear produced by anxiety, so therefore it must alternatively have a physical cause. Once the relationship is established as physical in nature, it can be very hard to break. You must employ logic and sound facts in order to realize that your symptoms are a consequence of anxiety and not physical disease.

You're going to be just fine and we'll talk more.

Best regards and Good Health