Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Is It Heart Attack or Anxiety?

Tuesday, 05 Apr 2011 12:36 PM

Question: Are there any natural treatments for anxiety or stress attacks that often are hard to distinguish from heart attacks?

All chest pressure or discomfort should be assessed by your doctor. You may think you are experiencing anxiety and/or chest pain, but you could be suffering from something more serious such as: infection, blood clot, heart attack, pneumothorax (lung collapse), embolism (blood clot in the lung), reflux disease, ulcers, disc disease, electrolyte disorder, thyroid disorder, diabetes, muscle spasm, and the list goes on and on.

Even with the elaborate medical diagnostics available, there will still be some people who want to diagnose themselves. I have ordered emergency coronary artery angioplasty and stenting for an 18-year-old male patient to try to save his heart; he had blamed his condition on a vigorous workout. I also have sent a 24-year-old female smoker and birth control pill user, who was sure she had indigestion and anxiety, to the catheterization lab for a right coronary artery blockage.

I’ve seen the woman with reported TMJ (temporomandibular joint) disorder and anxiety fall victim to unexpected cardiac arrest before she ever had a chance to see her doctor. She required resuscitation and an induced coma to protect her brain from her cardiac arrest and heart failure until she had recovered sufficiently.

Even professionals are easily fooled with chest pain diagnoses. If you’re ever wondering whether you’re having a heart attack, go to the hospital emergency department right away and place yourself in the hands of an expert in chest pain diagnosis: the emergency medicine physician.

Anxiety can be treated without prescription drugs. Relaxation techniques, meditation, hypnosis, yoga, and various calming teas can be far healthier than reaching for the Valium. Often a sedating antihistamine such as Benadryl or Vistaril will take sufficient edge off your symptoms.

Look for precipitants to the episodes and try to avoid them. Keep your diet low in caffeine and other stimulants, and be sure to get eight hours of undisturbed sleep each night. Shift work can complicate treatment, and sometimes melatonin and melatonin agonist treatment prescribed by your doctor will help with jet lag and shift work fatigue. Sometimes a low-dose beta-blocker such as Inderal will work well for stage fright. More involved management involving the use of a mood modifier, serotonin re-uptake inhibitor, or both also is possible.

If you have an anxiety episode that lasts for more than five minutes or recurring episodes, you should seek professional guidance without delay. Though anxiety may seem to be situational, sometimes it may be one of your only warnings of an underlying medical disorder. In women especially, fatigue and anxiety, experienced separately or in combination, may be your only warning of coronary artery disease.



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