Upset, Embarassed....ANXIETY dx???

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For the last week, I've had a resting heart rate in the 120's. Went in for a shoulder injection a week ago; they had me on an automated BP/pulse ox, noticed the heart rate and said, "Well THIS can't be right" and took my pulse manually. It was 124 at the time. Nurse instucted me to make an appt c my PCP regarding my "tachycardia".

I'm currently a few weeks from my LPN, and will graduate c my RN in 5/07. So far school has been great, no nerves on clinicals...the whole nine. I do have a hx of anxiety (I take Effexor and xanax 0.25mg prn). It's been helpful (my mom is terminally ill and it's been hard on me).

In the past my hr has never been a concern. Just the proverbial "butterflies" in stomach. The hr not going down is something new to me.

So last night after it wouldn't go down, felt like an elephant resting on my chest, I went to the urgent care center just to "ease my mind" so to speak. Again, it was up, but 120s is "not that high" according to the ED doc. Given an RX for ativan (after testing, chest xray, ecg, etc)....and told to make a fuv c my PCP.

I haven't been "feeling" anxious particularly. Usually when I am, it's just the "butterfly stomach feeling", which usually subsides with taking a "time out" and deep breathing, and xanax if I need it.

I'm embarassed. Well VERY EMBARASSED....that I was told it sounded like anxiety. So PVC's (heart flutters) are "normal" and hr in 120's is "normal".....again, according to the ED doc.

But...it feels awful.

Now I have to go in to my PCP and admit to this. Which is causing me butterflies just thinking of it......

What do I even say to him?

I'm starting to doubt that I made a wise career choice, given that anxiety can accompany a career in nursing.

And despite that it's "normal" for the PVC's.....it feels awful. Worse than awful.

36_33_14.gif And if this guy would get off my chest.....

Does anyone have any suggestions for me how to go about my upcoming conversation with my PCP? Without sounding like "hysterical woman"?

Anyone else have this happen to them?

Thanks in advance for any words of encouragement. Been in my room crying for the better part of today while kids are at school. I'm just so frustrated.

Thank you

Emma

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Specializes in Maternal - Child Health.

Please don't be so hard on yourself! You have a physical symptom, over which you have absolutely no control. That is nothing to be embarrassed about!

Now, make an appointment with your primary care provider. S/he knows you best and can determine the cause of your symptoms, and help you decide on a course of action. I have an arrhythmia (that has nothing to do with anxiety), and have found that minimizing caffeine and maximizing exercise work wonders.

You will feel better when you get this worked out. Best wishes to you and your mom.

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Specializes in CCRN, CNRN, Flight Nurse.

Tell him exactly what you've told us and exactly how this is making you feel - in whatever way(s) describes it best. Tell him what's going on in your life - school, clinicals, home life, social life, etc. There is no need to feel embarassed about anything.

If he doesn't do it (and I can't imagine why not), insist on an EKG and cardiac enzymes (CPK/CKMB and Troponin) and many a D-Dimer. A CBC, CMP and hormone levels (especially TSH and T4) wouldn't hurt either.

Let us know what you find out. Hope you get to feeling better.

Roxan

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Specializes in Nursing Professional Development.

Please make that appointment with your PCP and get a thorough evaluation. It might be something physical and not related to anxiety at all -- or maybe it is something physical that is triggered by anxiety.

Both my mother and my sister have had irregular heart rythms that occur ocassionally that have nothing to do with anxiety. It's a phyisical condition that can be treated with medication. Giving up caffeine (and any other stimulants) may also be necessary.

Then again, it could be something totally different that none of us has thought of. You won't know until you get a good evaluation.

As for "how to talk with the doctor ..." I would lead off the conversation with "I seem to have developed a problem with my heart rate ... Some people have suggested that it might be related to anxiety -- but I am not so sure becuase I don't seem to be terribly anxious when it happens. But I thought I should have it thoroughly investigated before jumping to conclusions."

Good luck,

llg

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I too get symptoms of anxiety. I also have a history of depression. My HR also gets up to the 120's and I'll be just sitting there. I get nauseous too and feel sick. I am tired quite a bit. I told my doctor about this and instead of listening to me we had a " discussion" about what a normal heart rate is and that my heart is okay. he completely missed the point. And then runs an EKG normal by the way. So I'm left feeling stupid and still get anxious. I just don't feel myself at times. All I wanted was some advice on what to do about it.

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Had exactly what you describe a few years ago, with the same medical dx I wouldn't accept. Turned out to be my thyroid. After insisting on a thyroid panel, doc called me once the results were received & immediatly put me on inderal. My heart rate stabilized, which made the anxiety go away-if you get my drift. Please, get a T3, T4 & TSH ASAP and research the various thyroid related websites to see if you can relate to some of the sx. PM me if you'd like to discuss this further. Hope all goes well for you. Good Luck!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Get a thorough work-up from your health care provider asap. Good luck and let us know how you are.

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Thank you for supporting and coaxing me to at least put the call in to the doc. I haven't heard anything yet today; most likely they either didn't get the ED report, they're busy, or they think I'm just over-reacting.10_12_9.gif

Someone mentioned the cardio exercise....I'd be afraid my heart would jump out of my chest and I'd have to go chasing it down the street...lol...if it's resting in 120's (and I used to get to 114 WORKING OUT), I would hate to see what it'd do.

By the way, the doctor's office just called and they can't see me until December 12th. Good thing he thinks I'm not dying....

Thank you so much for your encouragement and advice.

Emma

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Specializes in Med-Surg, Psych.

Hi Emma,

Please follow through with this... even though you cannot get an appointment for a few weeks, make sure you go. I have a similar problem and when I went to my MD, the EKG was "normal, except for tachycardia." Well, to me that is not normal! If you've experienced it, you know what I mean :p

I had a 24-hour Holter done and was told I have SVT. I am now on Atenolol and it has almost completely controlled all my symptoms.

Good luck to you,

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Specializes in OB, M/S, HH, Medical Imaging RN.

I've had the same condition for at least 25 years. I've been on Verapamil for the past 15 years. My HR would increase ever so slowly until one day I felt like I couldn't breathe and it was in the 120's -130's. I've had all kinds of cardiac tests done in the past and just recently (Heartview) everything has always been normal. I don't feel like it was caused by anxiety but I definately still occasionally feel PVC's when I'm anxious or hormonal. There's absolutely nothing to be embarrassed about nor is this unusual.

Last year when I was having more than just the occasional PVC, my PCP checked my TSH and it was out of whack. I'm on synthroid now and it has really helped.

P.S. I was told by a top cardiologist At Vanderbilt University Hospital that "no the increased HR is not dangerous and the PVC's are not lethal but if you run your car at 120mph 24/7 it's going to wear out alot faster and if the PVC's make you dizzy you could pass out driving and kill yourself or someone else." He promptly put me on Verapamil.

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