Is It Your Heart or Panic Attack Symptoms? — Page 3

Paroxysmal supraventricular tachycardia symptoms and causes

“PSVT is an abnormally fast heart rhythm that involves the upper chambers (the atria) of the heart. The heart rate can range anywhere from 100 beats per minute to over 200 beats per minutes,” Emory cardiologist and arrhythmia expert Michael Lloyd, MD, explains. “Technically, if a person were to go on a run and get their natural heart rate to over 100, this could be interpreted as a form of SVT, but doctors distinguish a naturally fast heart rate from fear, stress, and exercise as a normal sinus tachycardia, which is different than PSVT. We use the term PSVT (paroxysmal SVT) to describe the fact that true PSVT usually starts and stops suddenly and abruptly. The symptoms usually feel like a fluttering in the chest. Many patients describe being able to see their shirt move due to the rapid beating of the heart.”

Episodes can last for minutes to hours and usually stop on their own. Intravenous medicine called adenosine can interrupt the PSVT if the episodes continue unabated.

“In most cases, PSVT is simply from an abnormal electrical connection within the heart's conduction (electrical system). It’s analogous to being born with a freckle or mole on a certain part of the body. That is, it’s usually a sporadic, innocent developmental variation that isn't rigidly passed down through families,” Lloyd said. “PSVT is typically associated with an otherwise normal heart and does not increase the risk of heart attack, or future heart disease.”

While it isn’t life-threatening, the condition can threaten quality of life if it goes undiagnosed and untreated.

“The random, sporadic nature of PSVT makes it very hard to capture or demonstrate to healthcare providers,” says Lloyd, who is an electrophysiologist, a specialist in the treatment of heart rhythm disorders. “Unfortunately, this leads to the episodes being misdiagnosed as anxiety or panic attacks.” 

The confusion is understandable because panic disorder is common, affecting about three percent of Americans, according to the National Institutes of Mental Health. Like PSVT, panic attacks can come on suddenly, with fast heartbeats and feelings of intense fear.

An off-and-on racing heartbeat can be an important clue that PSVT is behind the symptoms, however. Smartphone apps that capture arrhythmias outside the doctor’s office can help make diagnosis of the condition easier.

“Luckily, smartphones now have empowered patients to have a readily available monitoring system to allow better capture and diagnosis of the episodes,” Lloyd says.

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