Anxiety disorders are a common type of psychiatric disorder characterized by anxiety or fear that does not go away over time.
Increased heart rate and heart palpitations are common symptoms of anxiety. Many patients who are having a panic attack may come to a hospital’s emergency department because they feel as if they are having a heart attack.
There is also some evidence that there is an independent anxiety-heart disease link. People who have generalized anxiety disorder seem to experience higher rates of heart attack and other cardiac events. It is thought that anxiety can alter the body's stress response, and people who have anxiety disorders have ups and downs that can result in high blood pressure, heart rhythm disturbances, or heart attack.
In addition, people who have heart problems are more likely to have higher baseline levels of anxiety. To add to all this, people who suffer from anxiety may adopt unhealthy habits such as smoking or overeating that increase cardiac risk.
Other symptoms of anxiety disorders vary depending on the specific anxiety disorder and may include:
- Excessive anxiety and worry that is difficult to control
- Feeling restless or on edge
- Being easily fatigued
- Irritability
- Difficulty concentrating
- Sleep problems
- Muscle tension
- Fears
- Chest pain
- Shortness of breath
How Are Anxiety Disorders Diagnosed?
Anxiety disorders are usually diagnosed with a psychological evaluation. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, provides diagnostic criteria for an anxiety disorder.
Lab studies to diagnose or exclude medical conditions that may cause anxiety disorders include:
- Blood tests
- Urine tests
Tests to rule out central nervous system (CNS) disorders that can cause anxiety include:
- Neurologic consultation
- Brain computed tomography (CT) scan
- Magnetic resonance imaging (MRI) of the brain
- Positron emission tomography (PET) scan
- Electroencephalography (EEG)
- Lumbar puncture
Tests to rule out heart conditions that can cause anxiety include:
- Electrocardiography (ECG)
- Treadmill ECG
Tests to rule out infectious causes of anxiety include:
- Rapid plasma reagent test
- HIV testing
- Lumbar puncture (CNS infections)
Other tests to rule out other physical causes of anxiety include:
- Chest X-ray
- Arterial blood gas analysis
What Is the Treatment for Anxiety Disorders?
Treatment for anxiety disorders often involves a combination of medication and/or psychotherapy.
Medications used to treat anxiety disorders include:
- Antidepressants
- Benzodiazepines, especially in emergency situations
- Anti-anxiety drugs
- Anticonvulsants
- Antihypertensive drugs
Types of therapy used to treat anxiety disorders include:
- Behavioral therapy and cognitive behavioral therapy (CBT)
- Computerized CBT (FearFighter)
- Interpersonal psychotherapy
- Relaxation therapy
- Supportive psychotherapy
- Mindfulness therapy
- Psychodynamic therapy (or insight-oriented therapy)
Other treatments used for anxiety disorders include:
- Cranial electrotherapy stimulator (CES) for treatment of anxiety, depression, and insomnia
Hospitalization may be needed to treat severe anxiety disorders in cases such as:
- Severe functional impairment (cannot meet own daily needs)
- Suicide or homicide risk
- Deficits in social skills
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https://emedicine.medscape.com/article/286227-overview
https://www.ncbi.nlm.nih.gov/books/NBK262332/
https://www.health.harvard.edu/heart-health/calm-your-anxious-heart