I went to emergency thinking I was having a bad Afib episode only to be told that I was having a panic attack! This is all so new to me, I am worried all the time. Now I don't know if I can tell the difference between the two. Has this happened to any one else? How do you tell the difference.
Panic attack: I went to emergency... - Atrial Fibrillati...
Panic attack
Written by
Slattery
To view profiles and participate in discussions please or .
Read more about...
31 Replies
•
The first time I had an afib episode I was told I was having a panic attack, my heart must have converted back to normal rhythm before they gave me an ecg. It wasn't until next time that they caught it. You may have gone into AF and then back to normal rhythm, and then just left with a fast heart rate and feeling very anxious - that's what happens to me sometimes. I now know how to check my pulse in my neck, if I can't feel a steady beat I know I have gone into AF.
It's easier said than done but try not to panic, it can make it worse as the adrenaline gets your heart racing faster. Although it feels like your heart may stop it's very unlikely, just sit still and try taking taking deep slow breaths.
Have you been diagnosed recently?
Hi Steve,
I was diagnosed two weeks ago with Afib, all test came back normal. I will be seeing an IR doctor in two weeks. I am new to this so I really got scared when I felt light headed, and my heart rate was 113.
Can I endorse what SteveA has written.
I regularly check my carotid pulse in my neck ( I cannot find my wrist pulse ) I use the middle fingers of my right hand to feel the pulse which is half way down my neck, to the left of my oesophagus. It is a steady thump-thump BUT if my heart is fibrillating then it is weaker and very muddled.
Jossikins and SteveA's advice is excellent.
I tempted fate by talking about it, I'm currently in AF after running up the stairs and have been for the last 2 hours. I've taken my flecainide pip and an extra beta blocker waiting for it to kick in, I'm currently trying to take my own advise by breathing slowly and trying not to get too anxious.
Got my ablation on Wednesday so really hoping it sorts me out!
Hi! I had just written a fairly long reply and I managed to erase it, irretrievably, from my screen, so here is a shortened version.
I have suffered, at different times as well as at the same time, both panic attacks and episodes of severe AF. The difference I have found is that, during a panic attack, however deathly one might feel, the heart rate stays fairly steady, even if the released adrenalin speeds it up. During an attack of AF, the word "steady" does not apply. The heart can go at an incredibly high rate (when I was connected to an overhead monitor in A&E at one time, it was frequently going well beyond 200 bpm) and is all over the place. It is understandable that an awful lot of people end up in A&E with a suspected heart attack only to be told that they have had a panic attack or one of AF.
It is more that 30 years since I suffered the crippling panic attacks that caused me to become severely agoraphobic for a good few years of my life, a difficult situation as I had five small children!
It is about 8 years since I was diagnosed with AF during recovery in hospital from pneumonia. I thought, at first, I was having another panic attack but I can now recognise the difference although one is just as scary as the other!
I guess our modern society and the pressures it places us under, as well as our sometimes unrealistic expectations of ourselves, have a lot to answer for. If it is of any comfort, I am now a very healthy, relatively calm, and more than averagely active 77 year old. Once I knew the panic attacks for what they were, I learned to control them rather than the other way round. With the AF, once those episodes were identified, I stopped being afraid of them. Finally, when I had a pacemaker fitted, because cardioversions and drugs were only having a limited effect, I found complete peace of mind because I no longer am aware of the AF, the PM controls it all and I am able to live the good life that it is now my good fortune to be able to enjoy.
I wish you luck and, eventually, a similar peaceful state of mind. I know it is easier said than done, but try to be philosophical and know that an attack of either panic or AF will not kill you but it will do its darnedest to intimidate you! Breathe in deeply and exhale slowly whenever you are feeling threatened. It works like magic!
I know that we all feel things differently and that my experience isn't necessarily the same with everybody, but I do know that fear is the enemy of us all and recognising it for what it is and denying it permission to take over is an important step in self preservation.
Good luck and a long life!
Jos.
I didn't know that a pacemaker can control AF
Hi,
A pacemaker doesn't control the AF, but it does hide it so thatthe wearer is not always living in fear of it. As I understand it, the PM kickstarts the heart if it goes below the given baseline (usually 60 bpm) which has never been my problem anyway, and holds things in check up to its programmed limit (which in my case is 130bpm). If my exercise level was to demand more than 130, I could be aware of the AF again but it would soon level out as the demand is removed to allow the PM to take control again. It is now more than a year and a half since the pacemaker was implanted, and I spend my summers doing some fairly vigorous cycling, and my pulse remains steadfast and sturdy. As I said, I am not aware of what is going on in the chambers of my heart, only that the evident beat is steady and my energy levels are good. I need, however, to stay on Warfarin, a small price to pay. I was offered the implant because cardioversions and drugs were not achieving a lot and, as I am in my seventies, I guess that it becomes more cost effective to implant an expensive little miracle worker such as this with the odds weighed against my surviving the10 year life of the battery. Needless to say, I have every intention of disproving those statistics!
batteries nowadays will probably last 15 to 20 years though many wont say so, so as to not disappoint!!!
Hi Jossikins I was relieved to see your article re: Pacemakers and AF which is a subject that I have rarely seen mentioned on this forum. I have had many episodes of Paroximal AF since 2002 which always seem to take a long time to return to normal whether in hospital or not, my present episode started on 8th May of this year. (I had successful cardio version on 27th Nov 2015 which lasted until May 8th.) I am fed up with this eternal merry go round and have come to the conclusion that the only way I can get any lasting relief is with a Pacemaker.( speaking as a layman)
I am in my 76th year. Is this just wishful thinking or do you think it is worth pushing my Cardiologist for.
Just check your pulse. If it`s regular with equally spaced beats, you`re probably having a panic attack. If it`s fast and irregular, it`s AF. As long as you`re getting the right advice and treatment for the AF, don`t worry - you`re not going to die! You really can, with time, learn to live a perfectly normal life with it.
There are millions throughout the planet that have it. I`m one of the old stagers.
What keeps me calm is a little gadget that works with a smartphone and a app on it. It takes a minu ECG with heart rate. It tells you if you ate I AFib and tells you when to see a dr. You can even email the results to your dr. It's absolutely wonderful. I will post a link I see i can't but it's AliveCor Cardia. I bought my gadget on Amazon and it was less than £100. Worthwhile and it keeps me calm.
Jossikins and wilen give good advice for that sort of feeling. We have to remember that everyone will feel different though so I try to be careful with what i say on here because it may not apply universally. I have been knowingly having attacks for 6 months and it has taken about that time to be fully investigated! In my case the conclusion is that my heart is structurally sound and therefore the PAF is not in any way life threatening. As mine started by being in an anxious situation I feel I am susceptible to minor panic attacks now but the more times I have AF (about every two weeks) and it returns to normal after 24 hours the more relaxed I am about it. I'm finding the anticipation of getting it and the false alarms worse than an actual episode, when I can continue to function fairly normally. I do check my pulse a lot now but not sure that is a good idea because if I feel it has missed a beat, imagined or not, I think it might trigger the alarm that sets it off so don't over do it or over think it.
The stroke risk is more tricky but again can make you more fearful than you need to be. It depends where you are on the scale. I have a CHAD score of 1 and all the professionals (including a top man for Essex, privately) say it is my call if I go on anti-coagulants or not. In the USA they would say yes but in Europe you need a score of 2 before they are recommended. Hence the ambivalence. Apparently it will reduce the risk in my case by 50% but that is in reality from 1 in a100 to 1 in 150 per annum.
As I say, everyone is in a different situation and there will be other viewpoints but trying to understand the risks without being alarmist or fearful is a great help to reducing anxiety.
Dave
I thought the anticoagulant s decreased the risk of stroke by a lot more than 50% no?????
Might be worth looking up the increased risk of haemorrhagic stroke to get a better understanding of the net risk of using anti-coagulants. I am 60 with a CHAD score of 1 and was advised not to take them. I assessed the risk myself as well. If doctors were masters of statistical risk management they might work as bookies or financial market traders. It's not their core discipline and this is highlighted by the confused way many of them explain risk to patients. For example, giving a woman the odds of a miscarriage if she has a sample of amniotic fluid taken from around an embryo for analysis but then not comparing this objectively to the risk of Downs Syndrome. A couple has already decided they do not want a Downs Syndrome child if they ask about this test. But if they subsequently decide not to have the test due to the likelihood of miscarriage have they actually understood the risk? Risk for each scenario is (likelihood) x (consequence). Doctors are not necessarily experts in risk management. People have to realise this rather than blindly taking advice based on misleading information.
I had panic attacks and have bad af attacks they were very different and easy to tell apart. However I think some early af attacks were diagnosed as panic attacks before the advanced arrhythmia symptoms presented themselves.
Both can be very debilitating. However my big arrhythmia attacks are unmistakable now.
I do hope you get sorted very quickly and get back on track.
If the deep breathing isn't having the desired effect when lying or sitting on the bed for example, I recommend sitting on the toilet and doing it! Sounds strange, but I find I can relax more in that position and better control my breathing. It also means you can totally relax your lower regions as well.
When I am in AF I have symptoms e.g. terrible weakness which stops me from taking even just a few steps, sometimes I feel my heart thumping. I was told by a paramedic during the first time I had AF that the best thing is to call an Ambulance as they can immediately hook you up and get a reading to say you are in AF and thats the proof you need for the Hospital staff. This was the quickest way for me to see a Cardiologist as my records showed 4 time in AF in a couple of weeks. Don't be afraid to call out an Ambulance. It will get things moving faster for you.
For what it is worth, in my experience, the two are completely different. Panic Attacks usually come on very suddenly and fill you with a sense of dread, a feeling of being out of control, almost like an out of body experience where you do not know what to do with yourself and the initial response is to run or get out from where ever you are.
Once an AF episode has ended and the heart rhythm is restored there appears to be nothing which shows it has happened. For six years I assumed I was having some sort of panic attacks as nothing could ever be found - after the events.
The most simple way to identify AF is by taking your pulse - the carotid in the centre of the side of the throat is usually easy to find and it's useful to practise when you are in normal rhythm. If you can identify your normal pulse and learn to recognise it, then the madness of the AF pulse will be very obvious. In AF the pulse will be chaotic and usually (but not always) fast. Ectopic beats can also be felt but they are more regular as they occur during normal sinus rhythm. I once put a sheet of A5 paper on my chest during AF and watched it jump about all over the place - interesting but probably not foolproof!
I bought an Alivecor heart monitor (now called Kardia) which works with either a smart phone or an iPad and produces a good single trace ECG. This helped me to learn what my heart was doing, record episodes for my physician to evaluate and take some sort of control of my condition.
How awful for you to feel so bad as to go to A&E and I would advise you to discuss it with your GP - perhaps even to get an arrangement for an emergency ECG during an episode.
I have also bought the Alivecor heart monitor,and it's so useful.Interesting to see the article in the Daily Mail this weak which said that doctors should have them in their surgeries, as it would save a great deal of time and money. (All those sticky wired pads that are placed on us,produce the same 30second paper read out !) I email mine to my computer,print them out,and take them to the cardiologist who finds them very useful. I find it very re assuring when I begin to experience some fast heartbeats ,begin to panic (heart rate escalates hugely ) and take a reading only to see it say "normal" Magically my heart starts to behave itself and slow down..!! It won't remove an a fib attack, ( still scares me stiff )but it's helping me recognise the difference,and as you say,take some sort of control by not over medicating.
Fear plays such a huge part in all of this. Fear when I'm not well,and fear when I am, because I'm anticipating it happening again--- so it's something I really am working on. Baby steps,but I hope I'm getting there.A symptom free holiday was marvellous ,so it's a start !
Hi Slattery,
During an AF episode the pulse rate is always irregular -it's good practice to become familiar with your pulse rate so you can give yourself pulse checks - a very basic ,simple procedure.
Cheers, Musetta
I bought myself a cheap pulse oximeter machine - the thing that clips on a finger when your BP is tested. If the readings are over 100bpm, and steady, I'm not in AF and should just relax a bit, I have been pushing it. If they are over 100 but unsteady, I'm definitely in AF, and should take medication. In fact, if it is unsteady at any rate I'm in AF, and medicate accordingly. For about £25, it is a really cheap and basic test, and I would not be without it!!
Unfortunately frequently they are very inaccurate if you are in AF. They could be reading 100 and it is in fact 150 or vice versa. As far as I am aware there are only two devices suitable for accurate recordings - the AliveCor (Kardia) and the Microlife WatchBPHome A (A model designation for AFib), which is approved by NICE. See main AFA website. Also wrist HB monitors are inaccurate. I proved that when cross checking for BOTH the Oximeter and the wrist monitor that I have.
I knew that the HR part of an Oximeter was inaccurate but I had thought that the SpO2 reading would be accurate but my sleep apnoea consultant said that the SpO2 level was also less accurate if you are in AF (though not by as big a % as the HR function).
I don't expect the reading to be accurate, what I am looking at is the consistency. If it shows 100, then 120, then 90, I know that it's AF, while if it consistently shows 100, it's probably not. I don't need it to show me that my pulse is faster than it's normal range (55-65), but I do want to see if it's steady.
It has even showed that I was in AF while I, and the GP thought I wasn't, because the pulse was in my normal range. I had always, previously had fast AF attacks. When I checked over a couple of minutes I never got the same reading twice, up and down by only 10 or 15 BPM, so 55-70 range, but I asked my GP to check with an ECG. He did so, grudgingly, more to calm my fears than anything else, but we both got a surprise - I WAS in slow AF, not sinus rhythm, and he agreed with my "diagnosis" and we were able to treat it.
I ignore the readings except as an indicator that they are not consistent. I agree that, if I was needing to know the actual readings at any one time it would not be a good enough piece of kit, but it definitely is enough to indicate AF in my case.
I was told I had asthma! I didn't.
I am really impressed to see how many intelligent and helpful responses Slattery's original question has engendered!
I have been amused, while watching the TV series "The Following" in which, Ryan, an FBI agent, pursues a psychotic serial killer, Joe Carroll. Carroll had previously stabbed Ryan in the heart necessitating a life-saving pacemaker to be implanted. Ryan chases Carroll through repeated scenes of violent escape from justice, demanding an unbroken running speed, up hills and stairs and cliff sides and over walls and alongside speeding cars, etc, etc. In reality, this would not be possible, even, I suspect, for the fittest stunt man! The pm is a little miracle worker but has, nonetheless, certain understandable limitations. Breaking the 4-minute mile is one of them. I guess the makers of the series believe, heavily, in "artistic licence"!
Not what you're looking for?
You may also like...
Panic attack and/or AFIB
rate. I know I was having a panic attack, but could it also have been afib? Does the heart have to...
Afib - anxiety and panic attacks
Hi HU community.
We afibbers all know that afib and anxiety/panic attacks go hand in hand. They...
Panic attacks / anxiety and a-fib
first time it happened - it was very bad and had a real impact. Maybe it happens 1 or 2 times a...
Panic attacks
I seem to lose confidence and have anxiety/panic attacks! Should I think about lorizipan or is...
First panic attack since surgery
way. The doctor I saw said I have a spell of depression because I went from severe health issues to...
I'm having a panic attack please talk me down 😨
Triggers of an attack
Fear or Panic as a trigger
panic when falling to sleep 
