Is it chest anxiety or something else?

[NewOne2023]

Hi guys.

For those who don't know my story so far, m/40, I've been diagnosed with PAF almost 3 months ago. Since then, I made a lot of changes to my lifestyle (no alcohol, mostly healthy diet, dropped 12kg of my weight, lowered my cholesterol substantially) and taking my meds everyday (bisoprolol and propafenone). Since the first diagnose I had a 20 day no afib run and at the beginning of Decemeber I had another two days of sporadic episodes lasting no more than 30min which I managed to stop withvagus manevuer to my surprise.

Since then I'm 40 days episode free. I'm waiting for ablation date which should be in 2 months max.

My questions is, in the last 10 days or so Ive been having more frequently waves of chest tightness like anxiety in the chest. Sometimes it lasts few hours and sometime it comes and goes in waves. Its not pain, but a chest discomfort like a weight sitting on my chest and I can feel it working. My pulse is always regular as far as I can check.

Now I'm wondering is it just chest anxiety or maybe something else? Like flutter or just palpitations. Usually I'm aware of my heartbeat.

I would mention that I did have a bad first few weeks after diagnose mentally. Anxiety was insane, mixed with fear, tiredness and dread. Luckily, it mostly subsided with me accepting the situation and taking proactive steps to try and tackle this with what I can.

In this first period I also took normabel, its anxyolitic that usually stops this feeling in my chest and calms me down but I don't want to take it every day because I don't want another problem with me getting hooked on this in addition to afib.

But, last 10 days or so this chest anxiety or discomfort kinda got more frequent and it bothers me in my daily activities. It comes from nothing slowly and goes quiet the same way. Is it possible this is atrial flutter since I don't know how it should feel, and if its only anxiety, what do you think I should do?

Overal I feel much better than 2 months ago, and being episode free for more than a month now is also helping mentally but I got this chest discomfort I can't quite grasp the source of it.

Any thoughts?

P.s. HR checked every morning and it usually stays at 115/60-70 so pretty ok. My resting bpms are 45-which is kinda low. Otherwise I do some activity, light running, basketball and long walks and all good with that. My heart rate goes up as prior to afib diagnose.

[Buffafly]

If the feeling comes on while you are exercising you should get it checked out immediately, in fact if it hasn’t previously been diagnosed as anxiety get it checked out anyway. It could be the slow heartrate but without a proper check no one can tell.

[NewOne2023 in reply to Buffafly]

Well quite the contrary. It usually starts when I don't do anything. Like sitting on my computer while doing some editing work or sitting in couch in front of the TV. I feel completley fine during exercise. In fact it boosts my overal feel. Justclike it did prior to my diagnose.

[Rainfern]

There are 2 reasons for getting clear medical advice for this chest anxiety. One is to get clarity on the underlying cause and find the best treatment. The second reason is that anxiety, in my experience, is reduced when our imagination is not left to fill in the gaps.

Heart and parasympathetic systems are so closely linked - but only further tests can truly tell you what’s going on.

I struggled hugely in the first few months of diagnosis. Even though I used to run relaxation and mindfulness groups as part of my job I needed to download a good beginner’s programme for relaxation and I’m using it to this day. I chose “”Balance” because I didn’t want music background and they know their stuff.

And never be afraid to ask for a second opinion. I payed to see an EP because I wanted time to work out the best route forward and my GP, bless him, is not a specialist in electrocardiology.

[secondtry]

I would pay to see a cardiologist promptly. There are many different permutations of drugs to deal with AF and you may just need to try an alternative.

eg I have same BP & HR in the mid 50's and my cardiologist put me on just Flecainide. He said an accompanying BB or CC would make me feel unwell and so far over 10 years he has been right as just 2 short episodes. My annual check-up is today so keeping🤞.

Re anxiety: I have found most relief from gaining info here, making different lifestyle choices and more focus on the spiritual side - for me that is prayer and closer interaction with Nature.

[TracyAdmin Partner]

Welcome to the Forum and for sharing your recent experiences, the members of the forum have already offered great advice, based upon their own experiences. Please feel free to visit the AF Association webpage for information or alternatively, contact the Patient Services Team at [e-mail]. uk

heartrhythmalliance.org/afa

Kind regards

TracyAdmin

[Exfat]

I sometimes get a tightness on my chest it’s neither anxiety or PAF it’s usually to do with muscle strain or overwork. Do you exercise regularly could this be the cause

[jeanjeannie50]

I really think you need to talk to your GP asap about these chest tightening episodes. That's certainly what I would be doing with your symptoms.

Jean

[Ppiman]

I don't think it's atrial flutter, particularly, which I had back in 2019 and more recently have had AF. Both create nigh on identical feelings in my experience. Like you, I also do get a strange discomfort in my chest, mostly under the left ribs and spreading into my back. It seems many people don't get this at all with their AF, but there we are. I often wonder whether mine isn't from my stomach, though, as I have a small hiatus hernia and take tablets for acid reflux. I doubt I shall ever find out. I have worried about mild angina, too - as I am sure you will have. My pulse is also often in the low fifties. My doctor is unconcerned, though.

Normabel is diazepam, so you're right that it's important not to make a habit of taking it or, in up to 1 in 3 people, I gather, the habit can become difficult and tortuous to break. Diazepam is a better muscle relaxant than anxiolytic, I think, so it might be helping you in two ways as anxiety always causes muscle tightness, especially in the chest region. I guess this is the cause, rather than heart trouble.

But - any chest discomfort needs a doctor to diagnose it, so, if you haven't already, that would be my next port of call.

Steve

[Auriculaire]

You should definitely seek medical advice. It is possible that it could be a side effect of Bisoprolol as this has been mentioned by other people. What dose do you take? Some people cannot tolerate beta blockers and have to take another form of rate reduction.

[NewOne2023 in reply to Auriculaire]

Well I'm on the lowest one, 1.25mg daily. And since my chest feeling stops everytime I take normabel (anxyolitic) I do believe it's anxiety symptom I feel.

[Auriculaire in reply to NewOne2023]

Have you tried supplementing with magnesium? This helped me a lot with anxiety. I used to have panic attacks usually starting when I was relaxing . Since taking magnesium biglycinate 400mg a day spread out in 3 doses they have disappeared.

[Singwell]

I've had a look at the responses and I agree it's worth checking out. I too get anxiety and also have a hiatus hernia. I also get chest sensations occasionally. Theyre like a pain or pulling inside but not sharp or crushing. Yours sound similar. I noticed you mention you get these sensations when leaning over the computer or slumped after a meal. Is it possible you have a hiatus hernia? Or are experiencing gastreo oesophagal reflux - aka heart burn?

I did speak to my arrhythmia nurse about these pains and she told me there were 3 possibilities:

Musculoskeletal skeletal (maybe you pulled a muscle)

Neurological- some type of nerve irritation

Gastric - as in heartburn

Cardiac pain she told me, is usually sudden and crushing. That reassured me because mine isn't like that.

Naturally it makes you anxious so please do look into it. Once you've ruled out Cardiac issues you can be detective about other possible causes.

[NewOne2023 in reply to Singwell]

What I meant was, I usually have this symptom while sitting or standing in front of my computer (I have adjustable table). I don't slump nor does it come after eating. Also it's not pain, just a discomfort in my chest like you would get from chest anxiety. I remember the feeling pretty well from the first few weeks after the diagnose. I was a wreck, in anxiety 24/7 and barely functioning during the day. Gradually everything settled as I started to accept my afib condition and taking some proactive steps. But this occasional chest discomfort is what is still here sometimes. And the fact that it always stops when I take an anxyolitic is telling me it's basically anxiety bothering me.

I got a feeling it's not cardiac and it's not a muscle strain. But I wanted to see if someone had an issue like this. Today for example, I haf it again while working on a computer for 30min, and I went for a walk outside, came home and it subsided without pills.

Who knows, maybe I developed an anxiety disorder during my first months of having afib. It really crushed me mentally and emotionally to the point I was seeing a psychologist.

[Singwell in reply to NewOne2023]

Thanks for clarifying. Anxiety has so many faces! Took me 2 years to find out that tingling and pins and needles I'd experienced soon after my own diagnosis was, in fact, a recognised symptom of anxiety. I hope you get clarity and then support for managing the anxiety. There was a post about it yesterday that I and others responded to. Maybe you saw it? Perhaps some useful ideas for you.

[WildIris]

Could be unrelated to heart, just some stage of digestion or hunger or even gas. Who knows. I've had this and mentioned this to my doc, and that's what he said anyway. I have noticed that passing gas does seem to relieve it sometimes.

[Goosebumps]

I have had similar issues to you . Very closely match the symptoms you describe.

I’ve had every test under the sun and eventually ended up with a stent in my LAD ( big artery!) but neither the cardiologist or the surgeon who put it in were convinced that it was the cause of my discomfort. I agree with them.

For me, it was anxiety coupled with chest muscle strain. Going through a divorce and forced house sale as I suffered heart issues was mind boggling and these things don’t happen overnight so it was a prolonged process.

If I get stressed out now, discomfort can return, and certain physical movements will kick off pain.

At the time people on the forum always said go to A&E if you have a chest pain. I would never have left the damn place if I had taken that advice. So I suggest that you get everything checked out, and once the doctors tell you that there is basically nothing wrong with your heart apart from AF, the anxiety might recede and the discomfort with it.

[NewOne2023 in reply to Goosebumps]

Well, in the last 2 months I had ultrasound of the heart, holter, numerous blood works and basically everything came out good. And I nwver experienced pain, its always a discomfort. The closest thing to describing it is a feeling of excitment before public speech, like a stage fright feeling in the chest.