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Is It Stress, Anxiety, or AFib?

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Posted by David Laslett, MD

From traffic jams to work demands and responsibilities at home, life can be stressful. Stress or anxiety can have physical effects, including the sensation that your heart is fluttering or racing. As a cardiac electrophysiologist — a doctor who specializes in heart rhythm problems — I know that those common stress symptoms may also be signs of atrial fibrillation (AFib), a heart rhythm disorder.

While stress itself can affect your health in a variety of ways, it’s important to recognize whether your symptoms are caused by stress, anxiety, or AFib, because AFib can lead to serious health problems if it’s not treated. To understand why, it helps to know the basics about AFib first.

What is AFib?

AFib is a common type of arrhythmia, which is an abnormal heart rhythm. Your heart uses electrical signals to regulate each beat. In people with AFib, these signals fire erratically. This causes the heart’s two upper chambers to beat out of sync.

The symptoms of AFib, which can occur occasionally or frequently, may include:

  • Skipped or fluttering heartbeats
  • Fatigue (extreme tiredness)
  • Light-headedness
  • Shortness of breath
  • Chest pain
  • Dizziness

Without treatment, AFib can lead to serious complications, such as heart failure and stroke. Treatment — such as medicines, procedures, or surgery — restores normal heart rhythms, helps control symptoms, and prevents complications.

Stress, anxiety, and AFib: What’s the difference?

Your emotions and mental health may affect your heart rate and its rhythm. This has to do with your body’s fight-or-flight response. When you’re stressed or anxious, your body releases adrenaline (a hormone) that prepares your body to respond to a challenge. For example, your heart rate and breathing go up, and your pupils dilate — which can feel like symptoms of AFib.

It can be difficult to tell the difference between these changes and signs of an arrhythmia — especially because stress can trigger symptoms of AFib. You’re more likely to experience symptoms of stress or anxiety when you are feeling strong emotions, while you may experience AFib at other times. AFib episodes also tend to start suddenly, while stress may build gradually. These differences are subtle. That’s why the best way to know if your symptoms are caused by AFib is to get a thorough medical evaluation.

If you experience AFib symptoms, tell your doctor. They may refer you to a specialist, such as the experienced cardiac electrophysiologists at the Temple Arrhythmia Program, to discover the cause of your symptoms.

If a patient is referred to me with symptoms of AFib, I review their medical history and do a physical exam. I’ll check their pulse and heartbeat to see if they are fast or irregular.

I typically also order diagnostic tests, such as an electrocardiogram, sometimes called an EKG or ECG. This noninvasive test, which records the heart’s electrical activity, may show if there is a problem with the heart’s rhythm.

Some irregular heart rhythms come and go, so they may not occur during an EKG. Because of that, I sometimes ask that patients wear a portable monitor, called a Holter monitor, for a few days or longer to check for any abnormal heartbeats that occur when they’re not in the office.

Patients may need additional tests, including an electrophysiology study, to help find out if they have AFib.

Calm your heart

Whether your symptoms are caused by Afib, stress, or both, lowering stress levels can have a positive effect on health. Here are some ideas for reducing stress and anxiety that I suggest to many of my patients:

  • Keep moving. Exercise can lift your spirits and lower your stress. Walking is often a good form of exercise for people who have AFib.
  • Try mindfulness exercises. Activities such as yoga, meditation, or breathing deeply help many people relax and cope with stress.
  • Make time every day for activities you enjoy. You know best what brings you a sense of joy, peace, and relaxation. That might be spending a few minutes working on a hobby, reading a book, listening to music, working on an art project, taking a warm bath, or watching some funny videos (laughter is good medicine!).
  • Prioritize a good night’s rest. Go to bed early enough to give yourself at least 7 hours of sleep. To help prepare your mind and body for sleep, establish a relaxing routine. For instance, dim the lights in your home and limit your use of TV, computers, or smartphones as bedtime approaches. You can better cope with stress when you’re not tired.
  • Talk about it. If something’s worrying or stressing you, talking about it may help you feel better. You might talk with a loved one, a friend, a counselor, a clergy member, or your doctor.
  • Ask for help when you’ve got too much to do. Have too much on your plate and too little time to do it? That’s a common source of stress and anxiety. Don’t hesitate to ask for help with tasks at work and home.
  • Pump yourself up with positive self-talk. Reinforce your spirits with “I’ve got this!” messages.
  • Eat heart-healthy foods. A nutritious diet not only helps you manage your AFib, it will also help you cope with stress better.

Get expert help to keep your heart in rhythm

The Temple Heart & Vascular Institute is a leader in treating the entire range of cardiovascular conditions. The specialists in our electrophysiology program have decades of experience in diagnosing and treating heart rhythm disorders, including AFib.

Whether you need a sophisticated diagnostic test or a routine or advanced electrophysiology procedure, we can help. Our electrophysiology doctors also work with our cardiovascular specialists to offer advanced procedures.

Request an appointment online with a Temple cardiac electrophysiologist or call 800-TEMPLE-MED.

Helpful Resources

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David Laslett, MD

Dr. Laslett is a cardiac electrophysiologist at the Temple Heart & Vascular Institute. He is board-certified in Internal Medicine, Cardiovascular Disease, Echocardiography and Nuclear Cardiology.

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