Heart palpitations are an unsettling sensation of an irregular or rapid heartbeat.

Often accompanied by anxiety, these palpitations can lead individuals to question the connection between their mental state and physical symptoms.

Although anxiety is a mental health condition, it has profound effects on the cardiovascular system. The mechanisms through which anxiety causes heart palpitations involve complex physiological responses, including the autonomic nervous system, hormonal changes, and the body's stress response. Understanding this intricate relationship is crucial for managing both mental and physical health.

The Role of the Autonomic Nervous System

The autonomic nervous system (ANS) is responsible for regulating bodly functions that occur without conscious thought, such as heart rate, digestion, and respiratory rate. It is divided into two branches: the sympathetic and parasympathetic nervous systems.

During an anxious episode, the sympathetic nervous system is activated, triggering the "fight or flight" response. This response includes the release of stress hormones like adrenaline and cortisol, which cause an increase in heart rate and can lead to palpitations.

Dr. Arash Javanbakht, MD, Director of the Stress, Trauma, and Anxiety Research Clinic, states "When the fight-or-flight response activates the sympathetic nervous system, it triggers stress hormones like cortisol and adrenaline, causing symptoms such as a racing heart, sweating, and shortness of breath."

Stress Hormones and Their Impact on the Heart

When anxiety triggers the release of stress hormones, these chemicals are designed to prepare the body to face immediate danger. While this response was evolutionarily beneficial, in modern times, the body is often reacting to perceived threats rather than actual physical danger.

Adrenaline, in particular, increases heart rate and blood pressure, while also heightening sensitivity to the body's own heartbeat. This combination can create a feeling of irregular or pounding heartbeats, which are the hallmark of heart palpitations.

Hyperventilation and Its Connection to Palpitations

Another physiological response that can accompany anxiety is hyperventilation, which occurs when a person breathes faster or deeper than normal. This leads to a decrease in carbon dioxide levels in the blood, causing a disruption in the body's acid-base balance. Low levels of carbon dioxide (hypocapnia) can trigger symptoms such as dizziness, lightheadedness, and heart palpitations.

Panic Attacks and the Sympathetic Nervous System

In cases of panic attacks, anxiety intensifies to a level that disrupts normal heart rhythms. Panic attacks are characterized by sudden, intense waves of fear, accompanied by rapid breathing, an elevated heart rate, and chest pain.

These symptoms are the result of a full activation of the sympathetic nervous system, which can overwhelm the body's regulatory systems. The heart may race in response to these signals, and palpitations may become more noticeable or frightening.

The Psychological Feedback Loop

The experience of heart palpitations during anxiety often feeds back into the anxiety itself, creating a vicious cycle. As individuals become more aware of their heart rate, they may begin to worry that something is wrong, which further increases anxiety. This psychological feedback loop can exacerbate palpitations, creating heightened fear and stress, which in turn triggers more physical symptoms.

When to Seek Medical Attention

While anxiety-induced palpitations are often harmless, it is important to distinguish them from more serious cardiovascular issues. Individuals experiencing persistent or severe palpitations, especially if they are accompanied by chest pain, shortness of breath, or fainting, should seek medical attention.

To alleviate the symptoms of anxiety-induced heart palpitations, addressing both the physical and psychological components of anxiety is essential.

Techniques such as deep breathing exercises, mindfulness meditation, progressive muscle relaxation, and regular physical activity can help reduce stress and lower the frequency and severity of palpitations. With the right approach, individuals can better manage their anxiety and mitigate its impact on their cardiovascular health.