RLR
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Hi Jen and welcome to the forum. All of the symptoms described are highly similar to those in other persons experiencing significant anxiety.
Realize that this type of anxiety is sufficient enough to produce physiological change that is universally misinterpreted by the patient as symptoms of illness or disease, most commonly the heart. It is not the case at all. Most importantly, this type of anxiety varies greatly from the normal sensations associated with situational anxiety, ie an important school exam, a date with a new fellow, a new job and that sort of thing.
With significantly intense anxiety, physical changes are experienced that produce fear and apprehension. The sensation of a lump in your throat is due to a phenomenon known as Globus, sometimes termed Globus Hystericus. In reality, nothing at all is lodged in the throat and the opening is not narrowed in the least. Despite this fact, many patients feel as though their airway is being restricted.
The actual cause for the sensation is stimulation by the vagus nerve of the musculature of the larnyx. Vagus nerve stimulation is also responsible for the palpitation events you are experiencing and contrary to belief, they are entirely incapable of causing your heart to experience difficulty of any kind and they do not place you at risk of harm to any extent whatsoever. Your heart will never be weakened or damaged as a consequence of these benign palpitations.
The sensation that you are short of breath is also due to influence by vagus nerve stimulation, which also imparts influence on the respiration cycle, causing the affected individual to feel as though they can't achieve an inspirational breath, which incidentally produces a calming effect as a result of stretching the lungs to full tidal volume. In persons with significant clinical anxiety, there is also a tendency to breathe in shallow patterns, which slightly alters blood gas levels and can produce light-headedness and effortful breathing.
If you are experiencing any type of GI disturbances such as indigestion or bloating, realize that this condition can produce upward pressure against the diaphragm. Your lungs expand by downward flexion of the diaphragm which permits the lungs to expand and fill with air. If indigestion and bloating is present to cause upward pressure against the diaphragm, it makes breathing feel difficult or labored, sometimes causing patients to huff or grunt and feel short of air. In reality, there is no respiratory distress at all, only a sensation.
You're going to be just fine and there's nothing actually wrong with your heart. You need to reflect upon any significant life changes that may be evident in your life presently that are highly capable of producing this level of anxiety.
Also realize that mild tricuspid regurgitation is extremely common and considered unremarkable on examination. It is not responsible for your symptoms and does not place you at any type of risk.
Best regards,
Rutheford Rane, MD (ret.)
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