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Is your heart racing from anxiety or an arrhythmia?

Heart palpitations. Chest pain. Sweating. A strange fluttering sensation in your chest.

These are common symptoms of anxiety or a panic attack, but they are also signs of a dangerous heart condition called atrial fibrillation, or irregular heartbeat. Although we all experience moments of heightened stress or excitement — when our hearts seem to “skip a beat” — it’s important to recognize when what you’re feeling is something more serious.

How to tell if you’re experiencing atrial fibrillation

Sometimes, an episode of atrial fibrillation can actually trigger a panic attack — or vice versa. 

Symptoms of atrial fibrillation, also called AFib, arrhythmia or irregular heartbeat, can vary, and some people have no symptoms. The most common symptoms include:

  • Heart palpitations
  • Fatigue
  • Shortness of breath
  • Chest pain
  • Lightheadedness

When it comes to telling the difference between AFib and anxiety, technology is your friend. Technological advancements are making it easier for you to keep track of your own heart rhythm. Sensors connected to the newer models of smartphones and smartwatches can monitor your heartbeat and notify you when something seems off. I’ve actually seen these devices discover hidden heart problems in some of my patients.

You can also make use of the heart rate monitor on a home blood pressure cuff or pulse oximeter. Using an objective monitor can help you determine if your symptoms are from anxiety or truly from an AFib episode.

Related: How to talk to your doctor about anxiety

So, you think you are experiencing AFib. Now what?

Next steps depend on how symptomatic you are. Some people feel bad enough that they need to seek urgent medical attention. In general, try to stay calm, see if you can check your heart rate and blood pressure, and call your doctor.

“Explore."

To diagnose AFib, your doctor may run some tests or might refer you to a heart rhythm specialist. The path to diagnosis might involve the following: a medical history and physical exam, an ECG and heart monitors, echocardiograms and stress testing. If you are diagnosed with AFib, there are many options for treatment including blood thinners, medications and minimally invasive catheter ablation procedures.

Related: Are you at risk for heart disease?

While the symptoms of anxiety and irregular heartbeat can be confusingly similar, don’t let that keep you from voicing your concerns. Untreated AFib can lead to more serious health conditions such as shortness of breath, fatigue, heart failure or stroke.

Whether your symptoms are due to AFib or anxiety, you don’t have to face it alone. Find a doctor who can help.

About the author

Praveen K. Rao, MD
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Praveen K. Rao, MD, is a cardiac electrophysiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas and Baylor University Medical Center. His areas of expertise include ventricular arrhythmias, premature ventricular complexes, atrial fibrillation, supraventricular tachycardia, pacemakers, defibrillators and cardiac resynchronization therapy. After receiving his medical degree from the University of Texas Health Science Center at San Antonio, Dr. Rao subsequently completed a residency in internal medicine and fellowships in cardiovascular disease and cardiac electrophysiology at Washington University in St. Louis, MO. He is also an active member of the Heart Rhythm Society and the American College of Cardiology.

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Is your heart racing from anxiety or an arrhythmia?