A factor largely responsible for the persistence of the problem is anxious heart monitoring when experiencing stress and arousal. Despite repeated negative medical tests, people with cardiophobia continue to believe and ruminate in an almost obsessive fashion that they suffer from a life-threatening heart problem.
Cardiophobia is defined as an anxiety disorder of persons characterized by repeated complaints of chest pain, heart palpitations, and other somatic sensations accompanied by fears of having a heart attack and of dying.
There are several possible causes of this anxiety. Perhaps you've witnessed someone having a heart attack or even been told that you have a chance for a cardiac event. And sometimes, as with many phobias, there's no clear trigger for the condition.
Cardiophobia is an anxiety disorder characterized by excessive worry about heart-related sensations and other somatic symptoms, accompanied by fear of having a heart attack and of dying (Tremblay et al.
Panic disorder – can be associated with cardiac disease or mistaken for heart attack. Feelings of extreme agitation and terror are often accompanied by dizziness, chest pains, stomach discomfort, shortness of breath, and rapid heart rate.
Cardiophobics are constantly listening to their hearts, with metaphorical ears out for even the slightest change in heartbeat, pulse, or blood pressure. People suffering from severe cases of anxiety disorder can even have a panic attack at seeing just a picture of a heart.
What causes panic attacks? The physical symptoms of a panic attack are caused by your body going into "fight or flight" mode. As your body tries to take in more oxygen, your breathing quickens. Your body also releases hormones, such as adrenaline, causing your heart to beat faster and your muscles to tense up.
“The fight-or-flight response speeds up your heart rate, so your body gets more blood flow,” explains Dr. Bibawy. “The increased blood flow gives you a burst of energy to fight or run from danger. That's why many people notice palpitations when they're scared, nervous or anxious — and it's completely normal.
The difference is that, when extra heartbeats in the upper and lower chambers are the cause of abnormal rhythm, symptoms may feel like an initial skip or hard thumping beat followed by a racing heart. When anxiety is the trigger, heart rate typically increases steadily rather than suddenly.
On the other hand, physical heart problems can contribute to anxiety. Approximately 70-80%⁴ of people who have suffered from a heart attack have greater levels of anxiety afterward — which can then put them at risk for developing further heart problems.
Due to this anxiety, sufferers of cardiophobia will have the same physiological experiences of a heart attack, such as shortness of breath, which further worsens the phobia.
Studies suggest that the high levels of cortisol from long-term stress can increase blood cholesterol, triglycerides, blood sugar, and blood pressure. These are common risk factors for heart disease. This stress can also cause changes that promote the buildup of plaque deposits in the arteries.
Increased blood pressure – Stress and anxiety cause cortisol levels to spike which increases blood pressure and heart rate. Frequent spikes in blood pressure weaken the heart muscle and could eventually lead to coronary disease.
Because it's a part of your being, anxiety won't go away completely. But you can lessen its grasp through understanding and self-awareness.
Wearable ECGs, such as those found in smartwatches and mobile apps, have recently become popular among patients. These ECGs can be applied to manage patients with anxiety, as they have been used to detect, monitor, and reduce symptoms of anxiety disorders.
Chest pain due to anxiety or panic attacks can usually feel like a sharp, stabbing sensation that starts suddenly, even if a person is inactive. However, they may be feeling stressed or anxious already before the chest pain begins. Common accompanying symptoms of an anxiety or panic attack include: dizziness.
Having normal blood pressure is a sign of a healthy heart. Normal blood pressure is below 120/80 mm Hg. High blood pressure is a systolic pressure of 130 or higher, or diastolic pressure of 90 or higher, that stays high over time.
Cardiophobia is the fear of heart disease or heart attacks. Cardiophobia patients engage in behaviors such as repeated medical consultations, monitoring their heartbeat, and avoiding certain situations. Treatment involves gaining the patient's trust and breaking the cycle of their obsession.
"Chest pain, rapid heartbeat and breathlessness may result when an insufficient amount of blood reaches the heart muscle," says Tung. (See "Symptoms" below.) One of the key distinctions between the two is that a heart attack often develops during physical exertion, whereas a panic attack can occur at rest.
Both autonomic activation and hyperventilation (via alkalosis) during panic attacks can lead to coronary artery spasm. This coronary spasm can then lead to myocardial ischemia and cardiac chest pain.
Stress cardiomyopathy is a condition caused by intense emotional or physical stress leading to rapid and severe reversible cardiac dysfunction. It mimics myocardial infarction with changes in the electrocardiogram and echocardiogram, but without any obstructive coronary artery disease.