Tuesday, October 02, 2007
Panic attack may lead to another kind of attack
Most people know intuitively that our psychological well being and physical well being are connected, but it is pretty hard to prove. Sure, depression, anger, hostility, even "Type A" behavior are linked with physical health problems, but no one is exactly sure why. It could be that stress hormones are released in such high concentrations that they negatively impact the heart. It might simply be that people who are susceptible to those behaviors also are more likely to skip doctor's appointments and engage in higher-risk behavior.

Still, a new study in a publication from the Journal of the American Medical Association caught my eye today (Full Story). After studying post menopausal women who had heart attacks or strokes, something interesting emerged as a potential cause. Researchers found that having just one panic attack seemed to increase the risk of future heart attack or stroke by threefold over the next five years (Full Study). That's right, just one panic attack, and it could have a devastating physical consequence down the road.

To be fair, the absolute risk of heart problems or stroke remains low. So a panic attack may increase your risk from 1 to 3 or 4 percent. Still, it really makes you think - if you are having a psychological meltdown, what exactly is it doing to your body?

Sometimes, it is hard to even tell the difference between a panic attack and a heart attack. The symptoms of panic attack might be chest pain, shortness of breath, dizziness, trembling, sweating or a feeling of choking. The signs of a heart attack might be the same, and the only way to tell the difference is to get checked in a hospital. So, how do you avoid a panic attack in the first place? Sometimes it is easier said than done, given that most of us are at risk of having at least one in our lifetime.

Have any of you experienced a panic attack? What do you think the relationship is between the mind and the body?
I'm fascinated by this new research. I'm a 50 year old woman. I started having panic attacks in my early twenties which we're misdiagnosed for several years. I stopped having them in my late twenties except when I fly. I ALWAYS have a panic attack when the door closes on the airplane. I continue to fly, but I only fly medicated. What is really interesting about this research is that every doctor I have ever talked to about the issue of panic attacks has insisted that there is no correlation between panic attacks and heart attacks although the symptomology is the same.
I am a Type A personality and I have had Panic/Anxiety Disorder since puberty or the last 26 years. I have studied the disorder for years and have written a book that is about to be published. My panic attacks at one point, during pregnancy, were so bad that there was only a few seconds of peace between them. This went on 24/7 for 12 weeks. I hardly slept and became very ill. At one point I couldn't even walk due to severe pain in my chest and shortness of breath. The doctors never took me seriously when I told them of this pain. "It is just anxiety and it is just in your mind." I believe I had a small miocardial infarction. While my disorder is controlled by medication there are periods when stress or other physiological factors cause breakthrough panic attacks. I feel a difference in my migraines as I get older and since I had a hysterectomy. They are worse and take longer to abort with medication. I feel eventually that I will suffer from a stroke or heart attack. I can trace the disorder back 4 generations and what is even more interesting is the fact that these generations contain frequent heart attacks and strokes. There may be some validity to this study.
I have had panic attacks since early childhood so this recent study concerns me. I, too, have been told there is no correlation between panic attacks and heart attacks. Even though I am on medication I still have breakthrough attacks. I wonder now if I should talk to my doctors about this study and see what I can do to reduce the likelihood of me having a heart attack. As if people with anxiety and panic don't worry enough - now this!
This is disturbing on so many levels. Panic attacks strike mostly women--and yet, with all the researchers in the world, we only NOW are discovering what any woman having a panic attack knows--that the heart IS being affected? Now, how long do you suppose it would have taken to discover this effect in MEN. I am appalled, but not at ALL surprised. Yes, as you can conclude, I have had several panic attacks. I also have been hospitalized for "irregular heart rhythms"...and then, on my last day in the hospital, was told "I needed to lose weight". Get real, medical community. I'm starting to believe you're all rather stupid.
There is undoubtedly a correlation. I think it can go both ways, 1) chronic anxiety/panic attacks lead to physical health problems, AND, 2) chronic (or even sudden onset) health problems lead to anxiety/panic attacks, which makes things worse. The consensus among my doctors is that #2 happened to me. Either way, it becomes a downward spiral, until there is a very dedicated doctor team (at least one primary care and one mental health therapist) to help the patient stop it... but the patient has to then be very attentive to their own health, willing to make ALL necessary life-style changes while undergoing treatment protocols for identified diseases.
I have had several panic attacks in my life. I started having them at the age of 20 while in college. They always seem to come on right after a really stressful time in my life; finals, end of relationships, changing jobs, etc. I am now 30 years old and have found a way to control attacks with medicines, diet and excerise, good sleeping habits, and knowing when not to burn the candle at each end.
I have experienced panic attacks in the past. After having other drugs for anxiety prescribed for me, I and my (then) doctor found Paxil, which I consider a godsend. As for your other question, Dr. Gupta, the mind and body are as closely related as any two entities can be. As the old joke goes, it's a case of mind over matter. If you don't mind, it doesn't matter

David Guy Fetzer
Fairhope AL
At 21, I was sent to a psychotherapist when I started having panic attacks. I happened to read an article that said "panic attack or heart attack?" It talked about mitral valve prolapse which is very common in women. I asked to be tested and it was confirmed I had a mitral valve prolapse which caused the panic attacks. The blood was not flowing properly thru my heart making it beat irregular and my fear made it beat faster causing a panick attack. As soon as I knew there was a cause for the attacks I stopped having them.
I also notice that I can get some anxiety, panic attack like anxiety, with movement in my lower intestine. When I eat lighter I feel better. Also, perimenopausal women are prone to rapid heart beat and like symptoms of panic disorder, hormone imbalances can cause it.
Having suffered severe panic disorder in my twenties and thirties, I was placed on Xanax, valium etc. I decided I did not want to become hooked on pharmaceuticals and opted to try hypnotherapy. After about 6 sessions my attacks left, never to return. (15 years ago). There is no doubt in my mind that panic attacks begin in the mind, though their symptoms are very physical.
My panic attacks are brought on by the fact that I have no insurance and I can't get any health care and most doctors won't see me. I have diabetes and a kidney transplant and heart issues. There are times when I think I am having a heart attack, but I guess I'm not, since I'm still alive
This is definitely very interesting and I second Lauren's comments on how long it's taken to study women's heart health. This new finding is especially intriguing, given the other recent finding that women who hold their anger in have poor heart health. I definitely think stress affects women's hearts more than we know (because heart disease research has historically been done primarily on men). Heart problems are really not taken seriously in women at all. I've gone to the doctor a few times with terrible chest pain and rapid, unsettling heart beats. I've been told anything from "Maybe it's actually that your stomach is upset. The stomach is right below the heart, you know" to "I think your bra underwire is pressing on your ribs and causing the pain. You should go buy a wireless bra" to "Did you run here? Maybe the heat is causing your heart to beat so fast." As ridiculous as that sounds, I'm not kidding!
Dear Dr. Sanjay

I'm glad you have decided to cover
this segment.

There is absolutely 100 percent
relationship.
The stress of everyday's life can
really get us down. Moreover, the
attempt to avoid stress is often
unrealistic.
When I get stressed out I usually
experience the panic attack.
Other than above symptoms, I
Sometimes experience insomnia.
I believe that insomnia is caused by stress from daily.
When I get stressed out I feel
higher heart beats and body
temperatures, as if I'm in danger
and preparing to fight or flee--;;
Thank you so much for sharing
valuable a piece of information with us. :-) take care.
I had a panic attack several years ago.I was only 22 but I still went to the doctor, thinking that I had had a heart attack. Surrounding that event I had constant feelings of tension and stress. During times of stress, we often receive stimulation from the nervous system, called "fight or flight" stimulation. This stimulates our bodies to either fight or run, and it can make even wild beasts flee or fight for thier lives. Although this stimulation is necessary to our survival, we are not meant to be in a constant state of "fight or flight". Our bodies are supposed to be relaxed sometimes too! However, constant stress, anxiety and panic attacks can trigger that "fight or flight" mode. I believe that if we are constantly recieving this stimulation, it stresses our bodies mentally AND physically. It does make us more alert, and it stimulates our hearts to beat faster and work harder. Maybe this is what increases our heart attack risk...
The mind-body relationships of panic attacks became a bit more apparent to me when I was struggling with co-morbid panic disorder and PTSD. Over the same period of time and under the same therapeutic conditions, panic attacks due to PTSD slowly diminished while panic attacks due to panic disorder remained unaffected. The comparison strongly suggests that my panic disorder is dominated by a physiological process (the body-side of the continuum) while my PTSD was dominated by a psychological process (the mind-side of the continuum). Both mind and body seem to play important roles, but the degree to which either might dominate can differ greatly.
I'm a (nearly) 50 year old Caucasian female. Beginning in my late 30’s and increasing through my early 40’s, I suffered from anxiety and occasional panic attacks, (especially when having to drive over bridges and on elevators.) I became afraid that I was losing my mind or having some form of heart problem or both. I sought medical assistance from my family doctor and (of course) he said it was “all in my head” and “it’s your personality,” then gave me medications to treat the symptoms.

I didn’t know what was worse, feeling out of it, poor short-term memory, and being lethargic, yet less anxious, or experiencing the extreme anxiety, my heart pounding, and feeling like I was going to faint. Then, on my own, (the same way I discovered I was gluten-intolerant and saved my own life,) I discovered that dairy products were the main culprit in causing me to have panic attacks. A couple of years later, I read an article posted on the mercola.com health website about how dairy products may cause the symptoms of panic attacks and may even be mistaken for schizophrenia in some people.

Today, now that I’m gluten and dairy AND medication-free, I haven’t had a panic attack or even felt overly anxious in at least six years. I still recommend that individuals troubled by anxiety and panic consult a physician before diet and life-style changes, especially if they are experiencing heart arrhythmias or other potentially serious physical symptoms. Yet, it is often the simplest and safest solution to a healthier and better life to educate ourselves about the types of foods we eat and the chemicals we use (and eat) and how they affect our daily lives and the lives of the people we love.
Low self esteem seems to play a significant role in the persistence of panic attacks. Most of my younger life I suffered extreme low self esteem and low confidence. I was usually anxious because I didn't feel confident in any area of my life. When panic struck I was 30 going through divorce. My disorder lasted about 6 years and after 10 years of no attacks, I was struck again while I was in an extreme stress situation.

During the first round, I underwent talk therapy and drug therapy for most of that time, but it wasn't until I became more confident and self assured that they disappeared completely. That was 20+ years ago.

Yes, I definitely believe there's a link between our minds and our attacks. When we feel unsure of ourselves, it makes sense that anxiety will exist. Once the cycle of fear, anxiety and panic gets going, it's difficult to stop it until we learn how to take control of who we are, how we think, and ultimately, learn how to control the anxiety and panic attacks by controlling our thinking.

Of course, there are probably cases where this won't work because of some biochemical issues that must be addressed.
My grandmother has had anxiety for her entire life, has never had a heart attack, she is now 92. Although anxiety and panic attacks MAY lead to heart problems, the result is not definite. You, of course, have to look at the statistics and find comfort there if you are worried about this.
I was 19 years old when I had my panic attack, and was an over-worked, tired, college freshman. The symptoms included hyperventilating, chest palpitations, cold-chills, and an intense fear of what may happen in the coming minutes. Even though it occured only once, the post-tramatic stress still makes me experience anxiety and fear.
Despite having gone to the hopsital, my physician, and a cardiologist, and being told I am "ok," I still don't feel that way.
The psycological impact of being in an emotionally distressed state has great tolls on the body. However, the extent of such physical "wear and tear" on the body can be controlled with centering the mind and, in my case, controlling my breaths.
I have them off and on now but when younger (early 30's) I had them all the time. I too thought I was having heart trouble and finally sought help. The Dr. I saw dianosed it and prescribed Klonopin. He said they would stop as quickly as they started but when I did have one to take the pill. He was right. He explained that stress was the culprit and the attack was the body's way of letting you know you need to slow down a bit. I'd just gone through a divorce. I felt fine or so I thought. They still happen from time to time and usually when I'm upset or stressing over something. I no longer take medication for them..but there are times when I wish I had it!
I had a condition they called, "Free floating anxiety" for several years. I tried anti-anxiety drugs, studied the physiology of panic attacks and then finally at some point I decided that fear was charging these attacks (I have had one heck of a life) I always say I am an "Oprah Show waiting to happen" somewhere inside of my mind I decided that once the attack hit and I allowed it to take over physically, well by then I was a goner. Full blown panic attack, thought I was dying every time. I came to the point where I just told myself, "Oh well, if I am going to die then so be it", I have actual conversations with myself where I will say out loud "Stop, right now" but I rarely ever have an attack anymore. Please knock on some wood. I believe I took care of the condition with my thinking. The mind is capable of incredible things. Blessings, Linda
What a good thing to tell people with anxiety and depression.
Whatever Lauren. Your comment is sexist from my perspective--a man who has lived with panic attacks since childhood.
I'm well acquainted with panic attacks. My attacks started over thirty years ago. In the beginning, the attacks were blamed on low blood sugar.
My panic attacks created problems for me. I became borderline agoraphobic. My social life suffered. I was the queen of avoidance.
Several years ago I agreed to take meds and practice breathing techniques to avoid attacks. I learned to live instead of just 'managing' my life.
I have suffered from extreme anxiety and depression for the last twenty years. As time goes by and I am subsquently exposed to more dramatic events in my life the level of anxiety and panic attacks increase. There have been several occassions when a panic attack would lead to incredible pain in my upper back, neck & chest and work it's way down my left arm leaving me certain I was having a heart attack. There is no doubt that emotional stress affects one's general health, well being and ability to function normally. I am living proof.
Dr. Gupta..appearently you're not aware that millions of people (mostly women) suffer from panic attacks throughout their lives. It's a horrible existence, but I, for one didn't get any help for 18 years. Doctors and researchers are so removed from reality, it is truly amazing. They know nothing about the effects of stress on the human body - which is devastating. I'm just disgusted reading you barely ever heard of panic and anxiety attacks. I take Nitro for my chestpains..and I don't have any plaques..but my heart did get damaged over the years. Just for your information, millions suffer from anxiety/panic attacks, generalized anxiety disorders etc. Learn to respect ppsychology..Marta
I had a panic attack once. I sincerely believed that I was having a heart attack, and I called 911. The dispatcher said, "That is not a medical problem" and hung up. I later went to my doctor, who did an EKG and said that it must have been a panic attack, that there was no sign of heart damage. I hope I never have another panic attack, and I feel very sad for those of you who have them frequently. They are REALLY scary. I sincerely believed that I was dying. The pain was terrible.
I don't know if I could really say I experienced "panic attacks". There is a disorder out there called dysautonomia, and I have the POTS form (postural orthostatic tachycardia syndrome) of this disorder. It's a form of autonomic nervous system dysfunction.

The ANS controls all the involuntary body functions such as, heart rate, blood pressure, digestion, ability to handle temperature changes, and the endocrine system. Many people who have this disorder suffer "panic attacks". Or is it?

When the body has orthostatic Intolerance(inability to handle gravity), the blood pressure drops, the body goes into a compensating tachycardia after an adrenaline surge. This looks very much like a "panic attack". Actually, there are a lot more disabling symptoms, but many ANS dysfunction patients are misdiagnosed with panic disorder, despite symptoms that are NOT reported with "panic attack".

Please see potsplace.com for more information. The medical community has very little knowledge of this disabling disorder.

What might appear as a "panic attack" could actually be a serious disorder of the ANS system.

Julie Tremp
I begain experiencing panic attacks shortly after my second child was born (isn't it interesting that so many who have commented began experiencing the disorder while hormone productivity was heightened?) and struggled mightily with a panic disorder for over 5 years. During that time, I was convinced I was suffering from a psychological disorder that would haunt me for life. Feeling terribly deficient, I read everything I could find on the disorder, a lot of which is contradictory and places the blame on how we "choose" to handle stress. Eventually, I began practicing restorative yoga and forgiving myself for apparently not having the psychological stamina to deal with life. The funny thing was, the more I relaxed and made peace with myself, the healthier and stronger I felt and the more I became convinced that this disorder has more of a physical origin than mental. Yes, the symptoms manifest themselves in excessively anxious thoughts and physical symptoms of panic - but those are all triggered by chemicals in the brain. I'm not a doctor or researcher so I don't know what the triggers are for that over productivity. I do know I'm not crazy or psychologically deficient. I do have a body/blood/brain chemistry that for a long time was my worst enemy. Thanks to the relaxation I found through yoga, I am now relatively panic-free (I can relate to the panic related to flying - I haven't overcome that yet!) My advice to the medical community is to consider, just consider that you don't know all there is to know about human physiology. Consider that for all our commonalities, there are still variations in individual physiologies that may make an individual react to a variety of stessors somewhat differently than your own experience. And study the heck out of anxiety disorders. They are so crippling to those who endure them, both physically and psychologically!
I have had and panic attacks for 20 years. I think i visited dr gupta in youngstown ny when i had my first one....perhaps from a tick bite.....remember me? :) i have sought care and paid thousands of dollars. nobody wants to take the time to do the baby steps. I have mitral valve prolapse, seems many of us do? and the woman at the airport that died in handcuffs perhaps had a panic attack? i blame the medical community for not telling her family she should not be someplace without a caring relative or caring health professional. also dr gupts, it is the ssri's that raise the blood pressure to stroke territory. mine went into stoke territory at the dr office, they even called an ambulance, but the clonipin reduced my blood pressure enuf to not have to go to the hospital. They tries all kinds of blood pressure meds to fix it for a year, to no avail. the only thing that brought my blood pressure back to normal was quitting all the meds, and all the doctors. They call us "clients" and dont think of us as patients. and ask us what we want them to do since we cant be "normal by tomorow" and ask US what we want THEM to do. I told em, you're supposed to be the doctor and know what to do......but they dont look at it that way anymore. and i have given up on them.
I have had panic attacks on and off since my early twenties. The worse one that I had caused me to be hospitalized. My heart was beating 180 beats per minute and I was standing still. The EMTs said I had experienced an episode of Super Ventricular Tachtracardya (sp.?). After the episode I entered therapy. It was a very scary incident.
Whatever, Kevin. I stand 100% behind my words. Yes, pain attacks hit men, too (I never said they didn't), but the incidence of women and pain attacks is higher thans men's; this according to every shrink I ever went to. And Kevin, please note that this study was about women. Did this offend you? Why ???? I've been in hospitals for depression and anxiety 4 times, and for every man there who had anxiety, there were 4 times as many women, who were told, time and time again that their "chest pains" were a symptom of mental illness...and put into mental hospitals, on their own or on their doctors advice, for that reason. Again, I must stress how incredibly sexist the medical community is towards women with chest pain. So stop it with the "sexist" remarks, Kevin: not every woman fighting for equal treatment is a sexist man-hater, even if the reverse doesn't always seem to hold true.
Yes. panic attacks are terrifying. It seems as though the emotions have not outlet when the attack strikes so it presents itself in distressing physical symptoms. People who undergo natural anxiety attack treatment will practice deep breathing because it is the first step in controlling how the body reacts to excessive stress. Breathing did the trick for me. But the thing that really helped was counting in my head as i tried to focus on calming down. It took the attention away from my fast beating heart.
Dear Dr. Gupta:
I had my first panic attack at age 26. It happened while sleeping. I woke up with a feeling of terror, unreality, and my heart was racing. It continued every night within 30 minutes of falling asleep. After getting checked out by my general doctor he found nothing physically wrong with me. My doctor prescribed sleeping pills so I could get some sleep. The main problem became fear of falling asleep and having another panic attack. Lack of sleep caused me to be a walking zombie during the day making it difficult to concentrate on work while feeling so sleepy.

The next step was to see a therapist who helped me learn coping skills.

I believe my panic attacks morphed into depression and anxiety in my early thirties when I moved to a new state and changed careers. I'm now seeing a psychiatrist to help me find the right medication. I take an anti-anxiety med and an anti-depressent combined with talk therapy.

By nephew who is 18 years old was just diagnosed with panic attacks and depression. I'm very concerned for him and have sent books on the subject.

I encourage you to continue to speak on the topic of anxiety and depression as we live in a culture where it is still a taboo subject although highly prevelent.

Thanks for sharing your knowledge with CNN viewers and readers of your blog!

Best,
G.Kelly
Chicago
i read all the comments and agree and see myself in all of them.my first panic attack was when i had my second child,they lasted 6 years.That was 28 years ago.I visited 3 different doctors because i was afraid the panic attack was going to cause a heart attack.All three doctors assured me that wouldnt happen,I lost all faith in doctors back then,they never took me seriously.I suffered alone and read all the books i could find.Because i finally understood what was happening in my body and why ,i learned to cope and they slowly left.I feel like i lost 6 years of my life.
I had my first panic attack after my first manic episode. I remember feeling so euphoric and then shifting to an extreme panic. It might have been the fact that my neurotransmitters were way out of wack causing an imbalance of how my body autoregulates itself centrally...i have no idea, but i did feel like i was having heart problems, and that was no fun especially at the age of 25!! I think that i have fully recovered from that extreme episode mainly because of medications like ssri's and also the fact that I am a medical student. I feel that being aware of the problem down to the biochemical level gives a feeling of security that there is an imbalance somewhere and that certain medications and behavioral techniques can be implemented before or at the onset of a panic attack to help prevent a serious and traumatizing event.
I started having panic attacks after I was sexually assaulted. They tried 3 different anti-depressants and 4 different anxiety medications and things really just had to resolve on their own. Medication helped some - not the anti-depressants because that turns out to generally be horrible for bipolar - but the only thing that helped in my case was time and a little bit of therapy. There are also physical causes of panic attacks (hyperthyroidism, etc) so I assume prevention would depend on the cause of one's panic attacks.
I wonder what the psychosomatic or hypochondriacal ramifications are of telling people with panic attacks that they could have a heart attack... sounds highly constructive.
Surgeon General's warning: worrying may lead to death; better yet - living may cause dying. I guess we're all in trouble.
It is amazing that doctors can systematically say that panic attacks mean nothing serious for health!

I have a reverse tale: I've only had panic attacks as a result of Grand-Mal seizures (3). These were caused by electrolyte imbalance from having adrenal glands ruined by transplant meds.
I was born with a severely malformed heart which lead to lung disease. This never caused me to panic growing up - I do not know why, since it was very painful and I almost died a number of times. I had heart attacks & heart rates over 150 bpm, and went on oxygen 24/7.
I lived until the age of 45 and then had a heart-lung transplant.
Maybe I lived much longer than expected because I DIDN'T get panic attacks.
I suffer from what I think are panic attacks at night WHILE I sleep. (I noticed the comment from Geraldine where she said she experienced attacks 30 minutes after falling asleep). I have panic attacks always within the first hour of falling asleep. I would love to learn more about why this happens when the body (and mind) is supposedly at rest. My doctors have not been much help.
I have an anxious profile, but never had panic attacks. This profile exists among my family (and my husband's family as well) in various forms: panic disorder, ocd, phobias, and autoimmune (such as lupus assocaiated with psychiatric distress) as well. One of my cousins with lupus and anxiety had heart bypass in his 30's.
Three of my and my husband's 6 kids are affected with severe anxiety and ocd, one of then seems to have chronic fatigue or fibromyalgia as well. I also know about panic attacks from my brother. I think heart symptoms can be common, but not the same as an all-out heart attack, though maybe anxious people are more susceptible to MI's down the line, so should monitor their heart health.

I do have spells of anxiety but not to so severe as my brother describes. I can get triggered to emotional reactions, anger and a racing heart for example, or feeling like wanting to escape when my kids' ocd is esp irrationally maddening or very restrictive on our life etc. However this feeling is distinct from pain of a heart attack in my experince. So I would guess a panic attack, despite physical symptoms, would primarliy be felt as psychological distress.

As a woman who has experienced anxiety and heart attacks, I think this must be true: i.e panic is primarily psychological/heart vs attack is primarily physical pain.

I have had unusual heart trouble that was not panic related but could apear so to doctors. My condition seesms to be related to hormonal changes or undetected endothelial or connective or vascular conditions, possibly caused by hormonal and/or autoimune flare ups.

I recently (age 43) had a spontaneous coronary artery dissection. My arteries are completely clear and I have low chloesterol, healthy BMI,healthy diet, I exercize, never smoked. However, I have been though severe stress related to 3 of my kid's anxiety disorders. One stopped eating due to fear of vomiting, another stopped attending school, another is not yet capable of attending the college to which she was accepted. So it it is rounds of therapy, various treatment attemps, medications, insurance headaches, IEP meetings, and scrutiny of our lifestyle and my mothering. (I also have 3 healthy kids).

When I had the sudden dissection recently, the symptoms were identical (but more prolonged) to symptoms I experienced 8 yers ago patpartum. At that time when I insisted it was not anxiety b/c it was definite crushing physical pain, and I was not under psychological stress at the time, I was simply dx with costochondritis rather than the first suggestion-anxiety. It was guessed it was somehow related psychologically ot trauma-wise to recently having given birth. My EKG looked normal and heart enzymes were not checked.

I was sent away frustrated (to experince 5 more sevre episodes) b/c I felt surely such distinctively crushing pain with numbness in my arms could not be just in my head or an inflammation of my sternum.

Now my cardilogist says I may have experienced spasms and/or dissections that healed, and are medically assocaited with the postpartum period. I took only ibuprofen which did not touch the pain.

My recent heart attacks (confirmed by angioplasty and subsequent thallium stress test) led to me receiving 4 stents and my heart muscle shows damage. The first MI was a dissection, for which I immediately headed to emgy room in severe crushing pain, and the 2nd a prolonged unstoppable spasm while in recovery, for which I ended up in cath lab a second time. My cardiologist speculates that such a severe spasm could possibly lead to dissection. The only way to stop the artery contricting was by catheterization. It does not seem conclusive whether there was also possibly a blockage(thius nitro was useless) or just a spasm that would not stop constricting. And whether a spasm led to the initial disscetion is not known.

The point is, if my troponin had not been checked in the emergency room (EKG was not clearly indicative of MI) the episode would have been dismissed as panic or anxiety b/c the emgcy doctor thought I was hyperventilating-not in severe pain. I was eventually transferred to local cath lab for emgcy angioplasty.

I beleive there is enough of a difference between a panic attack and a heart attack that they should not be confused. If someone is having a so called panic attack, or has been led to believe that crushing physical pain that bows you the the ground is just panic, do not let medical personnel just send you home. Check the heart enzymes and do not bring up anxiety in thr first place, it will then become the prime suspect.


Women esp post partum are more ssuceptible to this heart condition(spontaneous coronary artery dissection) than men and it happens at young ages with no risk factors, so it could easily be mis diagnosed as a panic attack. A woman has to insist that it is true pain that should be checked out, not just something in in her head.
This study sent shivers down the collective spines of all of us in the anxiety & panic attack community.

We were always told that anxiety & panic attacks CANNOT harm us. Period. Now this study suggests that may not be true after all.

I hope this news will galvanize researchers to spend more money on future studies to learn more.
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