I'm feeling extremely worried and tense since April, and it's affecting my breathing. I checked with my GP, did all the tests like thyroid, sugar, hemoglobin, and CBCthey're all normal. My ECG showed sinus arrhythmia. I'm on a tapering dose of Metxl 12.5 once a week after consulting with my GP. However, I'm still experiencing these anxious episodes where my pulse suddenly shoots up, and I feel hot, sweaty, and shaky. Sometimes, there's a headache, and I can even feel my pulse in my head. My heart races, and I get left arm and shoulder pain, along with nausea and loss of appetite. I rarely feel any chest pain, possibly due to anxiety, but it's mild. I've tried to calm myself, but this seems to have become a constant part of my health. Should I get another heart check-up because I did an ECG in June, or is this just anxiety? I'm really confused about what to do next.

Dr Mubarak Parveez B

General Practitioner

• MBBS
• 2+ Yrs

Consult Now

It sounds like you are experiencing symptoms of anxiety along with physical manifestations such as increased heart rate, body heat, sweating, tremors, nervousness, headache, and left arm shoulder pain. Since your recent ECG showed sinus arrhythmia and other tests were normal, it is likely that these symptoms are primarily due to anxiety. To help manage your symptoms, you can consider taking an anti-anxiety medication such as **Xanax (alprazolam)** at a low dose of 0.25mg as needed for acute episodes of anxiety. Additionally, you can try **Propranolol (Inderal)** at a dose of 10mg as needed to help with physical symptoms like rapid heart rate and tremors. It is important to continue with your tapering dose of **Metoprolol (Metxl)** 12.5 once a week as prescribed by your GP. If your symptoms persist or worsen despite these measures, it would be advisable to follow up with your GP for further evaluation and to discuss the possibility of a referral to a cardiologist for a more detailed heart check-up.

Answered 15 days ago