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  • Q&A with Australian Health Practitioners

    Why was atrial fibrillation diagnosed as panic attacks originally?

    Related Topics
    Atrial Fibrillation Cardiology & Vascular Health Panic Attacks
    The first few times I noticed palpitations I thought I was experiencing anxiety so I went to my doctor who told me I had a panic attack. This went on a few times until I saw a different physician and was told that it was atrial fibrillation. Why the confusion? What is the difference?
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    • Joe Gubbay
    • Dr Michael Davis
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    Joe Gubbay

    Clinical Psychologist, Counsellor, Psychologist, Psychotherapist

    I have worked in public hospitals as well as private practice over the past 25 years. As a clinical psychologist I treat depression, social anxiety, … View Profile

    Atrial fibrillation has a few overlapping symptoms with panic attacks, but they're completely different conditions. Just like the symtpom of being sweaty can be caused by fever, exercise, hot weather or anxiety, there are a few symptoms that can be a result of either atrial fibrillation or panic attacks.  These include an increased heart rate, palpitations, shortness of breath, chest pain, and feeling faint or lightheaded.  All of these symtpoms can also be experienced when someone is having a panic attack.  The difference is that atrial fibrillation is a physical problem with the heart's normal rhythm, whereas a panic attack is a period of high fear or anxiety.  

    In Panic Disorder, people develop a fear of having panic attacks because they're worried that they're the beginnings of something terrible, such as a heart attack or going crazy.  When symptoms of anxiety are experienced, that fear kicks in, resulting in increased anxiety, until the person is in a state of panic.  In your case, a physical problem has caused an abnormal heart rhythm, which you have correctly interpreted as a threat of some kind - in other words, you felt anxious.  

    It can be difficult to tease out whether the symptoms of anxiety have come first, or if an irregular heart beat has triggered anxiety, which in turn can cause further cardiac symptoms.  

    Thanks for writing in, I think it's a good reminder for those of us who treat people for panic attacks that we need to be sure that people are screened by their doctors for physical conditions that might be responsible.  

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    Dr Michael Davis

    Cardiologist (Heart Specialist)

    Electrophysiologist and pioneer in catheter ablation and in the management of atrial fibrillation. Expertise in arrhythmia device therapy, coronary care, echocardiography. View Profile

    Unfortunately it's quite common for heart rhythm disorders to be diagnosed as panic attacks or anxiety and vice versa. A carefully taken history will normally allow differentiation, but sometimes recording the heart rhythm during symptoms is required. I see many, many people experiencing palpitation while on a Holter monitor where the rhythm is quite normal. This, of course, is very helpful in guiding the direction of further management.

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