Does panic disorder cause palpitations?

Most people with Panic Disorder notice palpitations during a panic attack or a period of intense anxiety. The heartbeat may feel fast, forceful, irregular or as though it is fluttering. This happens because the body's alarm response releases stress hormones, which can make the heart beat more quickly and strongly.

Panic-related palpitations often appear alongside a sudden surge of fear, trembling, sweating, breathlessness, dizziness, chest tightness or a feeling of losing control. The sensation can be alarming even when the heart itself is healthy. It commonly settles as the attack passes, although worry about another attack can keep the body alert and make the sensation return.

Palpitations also have other possible explanations, including stimulant drinks, some medicines, an overactive thyroid, anaemia, an abnormal heart rhythm or another medical problem. A diagnosis of panic disorder should therefore consider the pattern of symptoms, your health history and an examination rather than relying on palpitations alone.

When palpitations start during a familiar panic episode, sit somewhere safe and loosen tight clothing. Breathe gently and slowly, allowing the out-breath to last a little longer than the in-breath; avoid forcing deep breaths, which can increase light-headedness. Remind yourself that the sensation is part of an alarm response and observe whether it eases.

Arrange a clinical review if the episodes are new, becoming more frequent, happening without anxiety, or interfering with sleep or daily activities. Keep a brief record of when they occur, how long they last, what you were doing, and any caffeine, nicotine, medicine or other trigger around that time. Treatment for panic disorder may include talking therapy, practical anxiety-management skills or prescribed medicine, depending on your situation.

Seek urgent medical help if palpitations come with chest pain or pressure, severe breathlessness, fainting, marked dizziness, confusion, or weakness affecting one side of the body. Also seek prompt assessment if the heartbeat remains very fast or irregular and does not settle, or if you have known heart disease. Do not assume a serious symptom is caused by panic simply because you have experienced panic attacks before.

You could ask: Could my palpitations have a cause other than panic? What details should I record during an episode? Do I need an examination or heart-rhythm test? Which panic-disorder treatment fits my symptoms and other medicines? What warning signs should prompt urgent help?