Need Help Heart issues and anxiety/panic

[Dcole461]

Hello all,

So I've been a recovering meth addict for 2 years. I've relapsed 3 times (1 night each time, not binges). I've completely changed my diet to focus on healthy living, lots of fruits and vegetables, no eating out, no snacking, etc.

The problem I'm facing is I have recurring heart palpitations. I used to have them with chest pains but my diet has fixed most of it. And I've had multiple EKGs, chest x-rays, stress tests and multiple doctors have told me nothing is wrong. But I don't see how that can be the case when I was a heavy meth user for 2 years.

Ironically, my anxiety over my heart health has only increased as the symptoms have gotten better. I don't have palpitations nearly as often, but I'm only 32 and can't even go jogging without having an episode. This has led to near daily panic attacks now.

I'm doing everything I can to take care of my heart, I don't drink alcohol, coffee or soda, nor do I do any drugs anymore (not even cannabis). And the docs say nothing is wrong, but it sure doesn't feel like it.

Does anyone have similar experiences with heart issues stemming from meth or other stimulant use? Did anything make them go away? Did you get a diagnosis? What helps with the anxiety? I got a prescription for clonazepam but I don't want to take them everyday. I can't take an SSRI because I'm bipolar and would also have to take a mood stabilizer so I'd like to get by on just the clonazepam if I can.

Any advice or kind words would be greatly appreciated because I hate living with this severe anxiety.

 

[Jabberwocky]

I totally get you, I haven't experienced anything to the intensity you describe but i have tinnitus due to injecting coke (basically the ringing never stopped, just got quieter) and every time i let me brain focus on that i get worried cos its like thats damage i can actually hear, to a tiny proportion of my circulatory system, so what the fuck have i done to the rest?!?!

well done on your recovery, it sounds like overall you are doing really.

you are right not to want to take clonazepam every day, i've been pretty addicted to benzos and it is not fun.

my completely unqualified pop psychology guess is that your anxiety over your heart is actually masking another, more deep seated and painful issue, which you are unconsciously displacing onto your heart because its somehow easier. are you getting any therapy?

it would be great if you can get to the point where you can exercise again because that has been the biggest help for me in dealing with my anxiety over the damage to my health. i'm gradually increasing the distance and pace at which i run and just knowing i'm actually doing something positive for my poor heart and lungs helps a huge amount.

 

[Deru]

The problem I'm facing is I have recurring heart palpitations.

Although they are incredibly annoying, if you've had ECGs done and doctors examined you, most of them are actually harmless. I have them all day long and the worst is when I lay down to sleep.

But I don't see how that can be the case when I was a heavy meth user for 2 years.

Most healthy adults have some varying degree of heart degradation, it's a strong organ that can take a beating, but it never stops every second of the day, 24 hours per day, and it eventually starts to wear. It takes a lot to go from heart degrading to heart disease or anything a doctor can diagnose you with, without a echo (TTE or TEE). Another thing worth mentioning, unless you've seen a cardiologist specifically, most doctors who don't specialize in the cardiovascular system won't give advice on the heart, from my own experience (3 open heart surgeries, artificial heart valve, pacemaker, heart disease from IV drug use)

 

[CFC]

As said, ectopic beats/palpitations are very common Dcole, even frequent ones, though some people don't notice them and for others it can be really bothersome.

Have you ever had a Holter monitor fitted so they can check over a longer period to see the frequency of events? This should - at least - give you more peace of mind as to the potential severity of what you're experiencing.

(PS if it helps to know I have a long history of heart issues including paroxysmal atrial fibrillation/PAF/A-Fib)

 

[Dcole461]

It takes a lot to go from heart degrading to heart disease or anything a doctor can diagnose you with, without a echo (TTE or TEE). Another thing worth mentioning, unless you've seen a cardiologist specifically, most doctors who don't specialize in the cardiovascular system won't give advice on the heart, from my own experience (3 open heart surgeries, artificial heart valve, pacemaker, heart disease from IV drug use)

Thanks a lot for your reply. I've since had a TTE which they said was normal. There was a slight irregularity in one of my EKGs so I'm going to wear a Holter monitor (appointment not for a few months).

Can I ask, do you have anxiety from your heart palpitations and how do you manage it? How severe are they? My anxiety surrounding them is getting better and some days they're barely noticeable. But then other days they are very intense and last for 5-10 seconds and I just feel like my heart's going to stop.

I'm guessing that since I haven't been diagnosed or treated for anything like what you've mentioned, I shouldn't be in any imminent danger. I've told my doctor I feel bad being so paranoid and wasting their time if nothing is wrong.

Thanks again for your help, I hope you don't mind all the questions.

 

[Deru]

Can I ask, do you have anxiety from your heart palpitations and how do you manage it? How severe are they?

So on my ECG, due to my total heart block - right bundle branch block and sometimes left - my p waves don't always form. That creates what's caused premature atrial contractions. My t waves are also inverted, and my QRS complex is wide.

So what happens is my upper atriums beat out of sync with the bottom ventricles, and my heart beats so hard it physically shakes my body. If you've ever been in a car with bad motor mounts, it's similar to that.

The good news is besides being incredibly annoying, it's harmless - minus some reduced blood flow into the ventricle to pump the blood out, maybe some light headedness and fatigue. As for how I cope, I drank, a lot. But my liver just went to shit, so... so far I haven't experienced it. I'm hoping it will happen less and less.

The biggest concern is if the PACs ever turn into full blown atrial fibrillation, so that does create a lot of anxiety for me.

Do you know what specifically was the concern with your ECG? It's worth mentioning a large majority of people who are completely healthy can have minor irregularities on an ECG, too.

Sometimes, if they do long testing like that, it's because the symptoms you're reporting don't add up to the data from tests they have given you. Especially with the heart's electrical system, it's so incredibly complex and so reliant on perfect ratios of potassium and magnesium, so it may only happen sporadically. I thought it was pretty cool to learn the potassium ions are actually what allow the electrical impulses in the heart.

 

[Dcole461]

Do you know what specifically was the concern with your ECG?

They didn't say, just that it could be nothing and that it wasn't an immediate red flag.

Sometimes, if they do long testing like that, it's because the symptoms you're reporting don't add up to the data from tests they have given you.

Yea, I definitely have palpitations but they never happen when they're listening or the ECG is running.

Especially with the heart's electrical system, it's so incredibly complex and so reliant on perfect ratios of potassium and magnesium, so it may only happen sporadically.

I've been trying to eat as healthy as possible. When I used to smoke meth my potassium levels were always low. I'd always get huge doses in the ER. Now I eat as healthy as possible and my potassium levels are good. I also make sure I get the RDI of magnesium because I've been deficient in that as well. What seems to be helping the most now is my B12 supplement (doc said I was deficient). Being deficient in that can also cause heart palpitations. I'm trying to cover all my bases before I get the Holter monitor so that if there is a problem, at least it's not with my diet.

Do you manage to exercise at all? Do you find that it helps? I'm trying to get back into walking to work but I'm still too anxious. I stopped after getting some scary fluttering episodes that would last 30-60 seconds but it could have been the B12. I haven't been eating out because of Covid and I don't really cook so I ended up undereating for a while. I'm going to give it another month so long as my symptoms keep improving.

 

[Deru]

I've been trying to eat as healthy as possible

Same. I learned if I adopt a gluten free diet, it really helps everything fall into place much easier. Myfitnesspal has been a life saver to track macronutrients ratios and also potassium RDI.

When I used to smoke meth my potassium levels were always low. I'd always get huge doses in the ER.

Same! Except for meth, IV heroin and cocaine. Whenever I get to 3.1 mmol/L my heart palpitations get incredibly bad. I'll never forget when I had sepsis, blood infection and endocarditis and they had to give me intravenous potassium through a hand vein with NO lidocaine. I literally screamed and screamed from the feeling of lava flowing up my arm.

What seems to be helping the most now is my B12 supplement

I just started 4 grams of fish oil per day for the omega 3 fatty acids and that has done miracles in so many aspects.

Do you manage to exercise at all? Do you find that it helps?

I have just been able to start exercising again. I'm up to 30 minutes of jogging per day, and yes, amazing positive changes so far.

 

[Deru]

If it helps ease your mind, here are the Report Texts from my last four ECGs. Both my electrophysiologist and cardiologist both dismiss it all as anything of concern. I actually replaced both of them with two new ones because I honestly thought they were not helping me, and the new ones said the same thing. My cardiologist explained to me, after noticing my frustration that it seemed no one was helping me, that these tests are so incredibly sensitive, they are more indicators for them to look at all the data available in context versus a definitive diagnosis. There still seems to be debate if I even actually had the heart attack (inferior infarct), even though every single ECG for years has said I have had one.

5/17/20	6/28/20	7/21/20	7/22/20
Normal sinus rhythm with premature atrial complexes Right bundle branch block Left anterior fascicular block Bifascicular block Possible Inferior infarct (cited on or before 28-FEB-2020) T wave abnormality, consider lateral ischemia Abnormal ECG When compared with ECG of 28-FEB-2020 13:23, Normal sinus rhythm with premature atrial complexes Questionable change in initial forces of Inferior leads T wave inversion no longer evident in Inferior leads Confirmed by [removed] on 5/17/2020 7:23:10 AM	Normal sinus rhythm with premature atrial complexes Right bundle branch block Inferior infarct (cited on or before 28-FEB-2020) Abnormal ECG When compared with ECG of 17-MAY-2020 03:08, Left anterior fascicular block is no longer present Confirmed by [removed] on 6/30/2020 2:14:08 AM	Sinus tachycardia Right bundle branch block Abnormal ECG When compared with ECG of 28-JUN-2020 22:48, Confirmed by [removed] on 7/22/2020 3:07:57 AM	Normal sinus rhythm Left axis deviation Right bundle branch block Inferior infarct , age undetermined Abnormal ECG When compared with ECG of 21-JUL-2020 22:24, No change from last ECG Confirmed by [removed] on 7/22/2020 7:08:10 PM

 

[Jabberwocky]

I have had a very similar experience to OP. About 5 years ago I binged on meth for 6 months (first time) and after I stopped it I had high anxiety which I felt ‘in my heart’ like palpitations. I’d previously been a big coke user so already had some worries about my heart. I went to a cardiologist and had every test imaginable and they all came back 100 % healthy. I also had my cortisol levels checked and they came back fine too. I did a bit of research and figured I had real anxiety but imaginary heart or psychosomatic palpitations.

I was at that time being prescribed a range of different SSRI’s and ATPs and I tried beta blockers as well but the horrible feelings in my heart persisted. They only got better when my father made me come to the pool with him every morning and swim laps. I found the very meditative and stress and anxiety relieving and after about a month of daily routine repetitive exercise all the heart symptoms resolved themselves. I also took some classes in Mindfullness and Cognitive Behavioural Therapy which helped keep my mind calm and my anxiety at bay.

I;m sorry I cannot recommend a specific medication, but I believe this kind of anxiety, felt in your heart even though your heart is fine, is part of the long term side effects of stimulants that are best relieved by healthy living, meditative type relaxation practices, and daily exercise. Swimming works wonders.