12/24/2023 0 Comments 2do debate presidencialWhen possible, medical history, including mental health history, should be assessed along with a physical exam and a 12-lead ECG. Mitigating the Risks of Variable Readings These devices could be helpful, but they might not be entirely clinically relevant until more is known about their applications in anxiety and cardiac response. If patients use wearable ECGs, the results may have mixed bearing on the actuality of waveform changes. 7 The authors emphasized that more research is needed in this area. However, one literature review in Brain Sciences that analyzed research involving these devices revealed mixed and unreliable evidence in support of their use. These ECGs can be applied to manage patients with anxiety, as they have been used to detect, monitor, and reduce symptoms of anxiety disorders. Wearable ECGs, such as those found in smartwatches and mobile apps, have recently become popular among patients. To learn more about the power of the ECG in today's clinical landscape, browse our Diagnostic ECG Clinical Insights Center. As the authors in a Frontiers in Neuroscience article emphasized, there's little evidence that either anxiety or depression can generate abnormalities in T-wave amplitude or QT-interval corrected for heart rate (QTc). However, as important as it is for clinicians to become familiar with these potential irregularities, it's also crucial to understand which ECG changes are less likely to be due to preexisting or short-term anxiety. Once the operator advised the patient to remain calm, a follow-up ECG conducted one minute later showed completely normal readings. 5 The patient, an otherwise healthy 28-year-old male, was reportedly afraid of being shocked by the leads. In one case study from the Egyptian Journal of Critical Care Medicine, such apprehension led to reported quadrigeminy in all ECG leads. In patients without a known clinical history of anxiety or other mental health concerns, short-term nervousness can also disrupt ECG readings. 3Īdditionally, certain high-dose or regular-dose anxiety treatments may induce QT prolongation, which has led Archives in Medical Science authors to recommend routine surveillance of patients being treated with tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and other therapies. Inversions are commonly discussed in studies analyzing patients diagnosed with mental health conditions, and in one study from the American Journal of Cardiology, authors noted that anxiety and depression affected T-wave inversion in opposite ways: depression made a person more likely to have inversions in the T-wave, while anxiety made them less likely to experience an inversion. Whether it is due to short-term test nervousness or a chronic condition, anxiety may be associated with certain ECG abnormalities, including T-wave inversion. So how can providers discern underlying cardiac issues from changes due to underlying or temporary anxiety? While the research is mixed, several case studies point to the importance of increased diligence with ECG readings and assessing patient history for relevant risk factors when possible.īecause many Americans are experiencing economic and other stressors tied to the pandemic-all while battling a public health threat known to cause lasting heart damage-remaining vigilant with ECG interpretation may be more important than ever. When false positives occur for rhythm irregularities or other concerns, preexisting anxiety or even test-invoked nervousness may be factors. 2Īdditionally, some manifestations of anxiety disorders can lead to abnormal ECG readings. 1 Sometimes these disorders can cause symptoms that mirror cardiovascular concerns, from increased heart rate (or a perception of one) to shortness of breath and chest pain, notes the Anxiety and Depression Association of America. An estimated 31.1 percent of Americans will experience an anxiety disorder in their lifetime, according to reporting from the National Institute of Mental Health.
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