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Anxiety And Heart Attack


Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure, rapid heartbeat, and sweating. It involves a future-oriented, long-acting response to a perceived threat or diffuse worry.

Types of Anxiety Disorders

There are several different types of anxiety disorders:

Generalized Anxiety Disorder (GAD): Persistent and excessive worry about daily activities or events that is out of proportion to the actual circumstance. People experience physical symptoms like restlessness, difficulty concentrating, and sleep problems.

Panic Disorder: Recurrent unexpected panic attacks with intense fear/discomfort, pounding heart, sweating, shaking, and feelings of impending doom. People worry about having more attacks and avoid situations where they have occurred.

Specific Phobias: Severe, illogical dread of particular things or circumstances that cause avoidance behavior and severe discomfort. Phobias that are common include fear of flying, animals, heights, etc.

Social Anxiety Disorder: Excessive fear and avoidance of social situations due to feelings of embarrassment, self-consciousness, and concern about being judged negatively by others.

Agoraphobia: Fear and avoidance of situations where escape might be difficult or help unavailable in an emergency, like being outside the home alone.

Separation Anxiety Disorder: Excessive fear or anxiety about being separated from people to whom one has a strong attachment.

Other types include substance-induced anxiety disorder and selective mutism in children.

Causes and Prevalence

Anxiety disorders are the most common mental disorders globally, affecting 301 million people in 2019. They can be caused by a combination of genetic, environmental, and medical factors. Women are more affected than men. Only around 27.6% of people with anxiety disorders receive treatment due to barriers like stigma and lack of resources.

Dealing with anxiety and anxiety disorders

Dealing with anxiety and anxiety disorders typically involves a combination of psychotherapy and medication. Here are some effective strategies:

1: Psychotherapy

  • Cognitive Behavioral Therapy (CBT) is among the best therapies for anxiety disorders. It assists in recognizing and altering unfavorable thought patterns and actions that fuel anxiety. CBT teaches coping strategies like exposure therapy to gradually face fears in a safe environment.
  • Acceptance and Commitment Therapy (ACT) uses mindfulness and goal setting to reduce discomfort and anxiety. It focuses on accepting anxious thoughts rather than fighting them.

2: Medication

  • Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like escitalopram (Lexapro) and fluoxetine (Prozac), are commonly prescribed for anxiety disorders. They can help regulate brain chemicals that control mood and stress.
  • Anti-anxiety medications like benzodiazepines can provide short-term relief from anxiety symptoms, but are generally not recommended for long-term use due to dependence risks.
  • Beta-blockers can help manage physical anxiety symptoms like rapid heartbeat and trembling.

3: Self-Care Strategies

  • Relaxation techniques like deep breathing, meditation, yoga, and visualization can help reduce anxiety. A balanced diet and regular exercise can also help with anxiety management.
  • Support groups provide a space to share experiences and learn from others dealing with similar issues. The most effective approach often combines psychotherapy, medication (if needed), and self-care strategies tailored to the individual’s needs.

Anxiety and Heart Attack

Anxiety and heart attack are closely linked. Here are the key points about their relationship:

  • Anxiety disorders, especially generalized anxiety disorder (GAD), are highly prevalent in people with heart diseases like coronary artery disease (CAD) and heart failure. The rates of GAD are significantly higher in cardiac patients compared to the general population. Anxiety disorders increase the risk of developing heart disease. People with anxiety disorders are 26% more likely to develop heart disease, particularly CAD and heart failure.
  • Chronic anxiety can lead to reduced blood flow to the heart, increased heart rate and blood pressure, inflammation, and endothelial dysfunction – all of which contribute to heart disease development. In patients with existing heart disease, anxiety disorders are associated with worse outcomes such as increased risk of major adverse cardiac events, severe disability, and mortality.
  • Anxiety can impede recovery after a cardiac event like a heart attack. The relationship is bi-directional – having heart disease also increases the risk of developing an anxiety disorder. A diagnosis of heart problems can raise baseline anxiety levels. Potential mechanisms linking anxiety to heart disease include sympathetic activation, impaired vagal control, reduced heart rate variability, oxidative stress, increased inflammatory markers, and unhealthy lifestyle behaviors associated with anxiety.
  • Treating anxiety disorders through psychotherapy (e.g. cognitive behavioral therapy) and medications (e.g. antidepressants) may help improve cardiac symptoms and outcomes in heart disease patients with co-existing anxiety.


Several kinds of medications are frequently used to treat anxiety disorders, including:

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are a type of antidepressant that are considered the first-line medication treatment for generalized anxiety disorder and other anxiety disorders. They function by raising serotonin levels in the brain. Examples include:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

SSRIs typically take 4-6 weeks to take full effect. Common side effects include nausea, insomnia, diarrhea, and headaches.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs are another class of antidepressants that can treat anxiety by impacting serotonin and norepinephrine levels. Examples are:

Duloxetine (Cymbalta)

Venlafaxine (Effexor)


Benzodiazepines like alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan) are fast-acting anti-anxiety medications that enhance GABA activity in the brain. They provide quick relief from anxiety symptoms but have a risk of dependence with long-term use.

Other Medications

Other medications sometimes used include:

  • Buspirone (BuSpar) – an anti-anxiety medication
  • Tricyclic antidepressants like amitriptyline (Elavil)
  • Beta blockers like propranolol for performance anxiety
  • Anticonvulsants such as pregabalin (Lyrica) and gabapentin (Neurontin)

The choice depends on the type of anxiety disorder, coexisting conditions, potential side effects, and patient preference. Psychotherapy like cognitive behavioral therapy is also an effective treatment for anxiety, often used in combination with medication.


In summary, anxiety disorders significantly increase cardiovascular risk and worsen prognosis in heart disease patients. Proper diagnosis and treatment of anxiety in cardiac patients is crucial for improving overall health outcomes.


1: How to relieve tension in neck and shoulder from anxiety?

Here are some effective ways to relieve tension in the neck and shoulders caused by anxiety:

Neck Stretches

Perform gentle neck stretches to release tightness in the neck muscles. One good stretch is the neck tilt – tilt your head towards one shoulder until you feel a stretch on the opposite side of the neck, hold for 20-30 seconds, and repeat on the other side.

Shoulder Rolls

Slowly roll your shoulders backwards and forwards in a circular motion. This helps relax the shoulder muscles.

2: Can anxiety cause shortness of breath?

Yes, anxiety can definitely cause shortness of breath. This is because anxiety triggers the body’s “fight or flight” response, which leads to physical symptoms like rapid breathing (hyperventilation), chest tightness, and feeling like you can’t get enough air. The shortness of breath from anxiety is caused by changes in breathing patterns due to the release of stress hormones like adrenaline. When anxious, people tend to take rapid, shallow breaths in an attempt to get more oxygen, which paradoxically makes them feel more short of breath.

3: What is 333 rule for anxiety?

  • Name three things you notice when you take a look around.
  • Next, identify three noises you hear.
  • Lastly, make three movements with your body: your arm, fingers, or ankle.

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