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Anxiety and the Fear of Cardiovascular Problems

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated October 10, 2020

Anxiety and the Fear of Cardiovascular Problems

Anxiety is fear. It's the activation of the fight or flight system, which is the system that your body uses to react to fear responses. Anxiety disorders occur because the body is activating that response when no danger is present.

But in addition to being fear, anxiety also causes other fears. That's one of the reasons that anxiety can be hard to treat without help. One of the fears it causes is a fear of cardiovascular problems (poor heart health), and often those fears end up contributing to further anxiety.

Doctor First - Anxiety Second

Your heart health is never something you should leave to chance. The reality is that you could have anxiety and still have a heart condition, or have a heart condition whose symptoms are causing anxiety. Always talk to your doctor first, to eliminate any more serious disorders.

But anxiety really does cause issues that lead to a fear of cardiovascular problems.

Symptoms That Create Heart Health Anxiety

It's possible to fear for your heart health as a symptom of anxiety without any physical symptoms present, because anxiety itself can create fears without a trigger. But anxiety - especially panic attacks - can cause several physical symptoms that are nearly identical to what people think of when they think about their cardiovascular health:

  • Chest Pains Chest pains are considered a warning sign of a heart attack. Unfortunately, they're also a common anxiety symptom. There are subtle differences in both severity and placement, but any time you experience chest pain it's possible to think it's due to your heart.
  • Rapid Heartbeat Rapid heartbeat is also a symptom of anxiety, and often runs concurrently with a lesser known symptom which can best be described as "heartbeat awareness." It's not just that your heart speeds up - those with anxiety can also "feel" their heart more, so that when it speeds up it feels like it's about to stop.
  • Lightheadedness/Difficulty Breathing Cardiovascular problems are associated with fainting and death. Lightheadedness, difficulty breathing, and trouble thinking are all common physical symptoms of severe anxiety attacks, which one expects to experience if they were suffering from a serious heart condition.
  • Tingling Limbs and Muscle Weakness In addition to feeling faint, the muscles - especially on the hands and feet - may start to tingle with severe anxiety, and possibly even feel so weak that you do not think you can stand. Combine this with other symptoms of anxiety like trouble swallowing and it starts to appear like your heart is no longer pumping blood.
  • Feeling of Doom While not necessarily a physical symptom, anxiety attacks also have a feeling of doom as a symptom. Meaning, in addition to suffering from all of these heart related symptoms, you're also likely to experience an extended period of time where your mind and body are convinced that your world is ending.

All of these combined make up severe anxiety. All of these combined also cause a person to develop severe health fears, because it is hard for the mind to believe that all of these symptoms are due to a mental health disorder. In fact, because of anxiety itself and the feeling of doom, even if you know for a fact you have panic attacks it becomes exceedingly difficult to accept that belief, since anxiety is always telling you that you need to worry.

What's Really Going On

It would be disingenuous to say you do not have a heart condition, because there is no way to know until you talk to your doctor, which you should under such citcumstances. But let's assume that you're like most people - your doctor is going to tell you that nothing is wrong with your heart.

So then why are these cardiovascular problems occurring? The answer is likely to be hyperventilation.

Hyperventilation is also known as "over-breathing," and contrary to popular belief, it's not caused by getting too little air. It's actually caused by breathing out too much carbon dioxide.

Your body needs the right balance of carbon dioxide to function. When you breathe too quickly (or breathe in more oxygen than your body needs), your cells are drained of their carbon dioxide and your entire body is forced to work much harder in order to function. Your blood vessels constrict, your brain gets less oxygen, and your heart has to beat extra fast because your blood is slowing down.

This what causes the vast majority of the symptoms of a panic attack. And what makes it worse is that hyperventilation makes it feel like you're not getting enough oxygen, even though the reality is that you've taken in too much. Because of that feeling, most people continue to hyperventilate even more in order to try to get a "full breath" only to hyperventilate even further and experience a worsening of the symptoms.

When you combine these symptoms with anxiety, you get a constant feeling that your heart is in poor health.

Hypersensitivity - Making Matters Worse

In addition, those with this type of anxiety tend to develop another issue known as hypersensitivity. This is when the mind and body become so connected that a person feels every single sensation their body makes as though it was amplified and a sign of something very severe.

Anxiety can cause the heart rate to speed up, muscles to experience tension, etc. When they do, a person with hypersensitivity always notices, and not only do they notice - they also feel it stronger than those that do not have hypersensitivity. This is why it appears that you still have heart problems even when you're not having an anxiety attack. Your heartbeat speeds up for whatever reason (sometimes for no reason at all) and you always feel it in a way that seems amplified - as though something is wrong.

How to Tell the Difference Between Cardiovascular Problems and Anxiety

It would be great if there were a simple way to tell whether or not you have cardiovascular problems or anxiety, but unfortunately the symptoms are too similar. Talking to your doctor is the only way to find out for sure. There are a few ways to tell the difference, but they aren't a guarantee. Some examples include:

  • Chest pain from a heart attack tends to radiate throughout your left side and shoulder. Chest pain from panic attacks tend to be more localized.
  • Heart attacks tend to cause irreparable heart damage. Panic attacks cause no permanent damage. For better or worse, multiple heart attacks will often be fatal. Once you've gone through more than one panic attack, it's extremely unlikely it's anything serious.
  • Panic attacks tend to follow a pattern, where they peak at about 10 minutes in and slowly decline. Heart attacks can conceivably follow that pattern, but it's uncommon.
  • Panic attacks may cause people to feel faint, but they rarely faint. Heart attacks can cause people to lose consciousness.
  • Panic attacks often affect young and healthy people. Heart attacks in young men and women without a previously diagnosed heart disorder are extremely rare.

Clearly this is by no means a comprehensive list, but these are some of the ways you can tell. As you can see, it's fairly difficult to tell the difference.

Panic attacks also cannot cause a heart attack unless you have a serious heart condition already. Even then it is extremely rare for a heart condition to be exacerbated enough by a panic attack to lead to any type of cardiovascular problems.

Your Next Steps to Prevent Anxiety Over Your Cardiovascular Health

Even though it is extremely likely that your issues are related to anxiety, it's always important to make sure that you speak with your doctor. Your heart is never something you should leave to chance.

But two things should be noted:

  • Once your doctor tells you your heart is fine, you need to accept it.
  • Anxiety is going to make it almost impossible for you to accept it.

It would be great if seeing a doctor was enough, but the truth is that almost no one with anxiety finds it easy to accept a "healthy" diagnosis. Because of the way anxiety causes constant attention to be placed on your cardiovascular system, almost everyone with cardiac fears will continue to have those fears after the doctor's visit is over. Don't expect a diagnosis to rule your anxiety out.

The first thing you need to do is practice better breathing. Since hyperventilation causes most of the symptoms, it's important to start breathing more efficiently. Take slow, controlled breaths, and fight the urge to yawn or expand your chest. The moment you start to feel as though a panic attack is coming on, try the following:

  • Breathe in slowly, taking at least 5 seconds.
  • Hold for two seconds.
  • Breathe out as though whistling for 7 seconds.

Never rush the air out of your body, and try to give yourself time to regain your carbon dioxide level. Don't hold your breath for too long though since holding your breath can cause similar symptoms and may exacerbate your anxiety.

Controlling your breathing won't stop your panic attacks, but they should reduce the severity, and for many that alone can help reduce the frequency of panic attacks in the future. Once you've controlled your breathing it's time to combat your overall anxiety, which in turn will decrease your cardiovascular health fears.

Questions? Comments?

Do you have a specific question that this article didn’t answered? Send us a message and we’ll answer it for you!

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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