First, take your pulse

“In cardiac arrest, the first step is to get your pulse first.”

–God’s House Samuel Shem

That famous line told by Med students is clear and true. In moments of confusion, we are reminded that we must pause enough time to check in ourselves. As a cardiac electrophysiologist, I have now come to see that the need for internal recognition does not simply apply during Code Blue. It applies to our daily lives. There, uncertainty, information overload, and widespread anxiety are increasingly challenged. Sometimes our bodies don’t always reflect reality, but we can betray us with symptoms that can trigger Devastating thoughts.

When the heart competes, the heart often continues

Race throbbing, or “moving pit,” is a common symptom seen in the office or in the ER. That may be reflected fearexcitement, or excessive symptoms, but also due to a short circuit in the heart’s electrical system called arrhythmias. The challenge is that symptoms of panic and arrhythmia often appear to be similar on the surface. Rapid heartbeat, shortness of breath, dizziness, and even chest discomfort. And in our fast-paced culture, these experiences are often misdiagnosed or minimized based on appearance. The key is to learn to interpret them accurately and compassionately.

The story of two patients

I remember a healthy 20-year-old woman who announced after several ER visits due to a “panic attack.” Her symptoms followed a pattern: sudden, thrilling heartbeat and fear. By the time she arrived at the ER, her heart rate had been normal, so she was diagnosed anxiety. In one episode, she used her Apple Watch to record her ECG (ECG). She showed it to me and the diagnosis was clear: ventricular central tachycardia, or SVT, is a type of arrhythmia that often affects young and healthy people. Her episode occurred at rest stress. That details fit how the SVT behaves. This allows premature beats to kick off episodes in that they often occur when heartbeats are slow. If it starts suddenly, it will suddenly stop. Many patients describe it as a light switch effect. It was handled using a catheter ablation procedure that fastened a short circuit. Her symptoms resolved without a “panic attack.”

Her story is in contrast to a 50-year-old executive who juggled deadlines, consumed a lot of caffeine and dealt with his stress in self-medicine. alcohol. His mind is tense, a meeting, a discussion, or when I’m lying I wake up at 2am and think about everything I still need to do. He was worried that he might have a serious heart condition, especially since his father died of cardiac arrest. But when we monitored his heart, what we found was sinus tachycardia: the normal rhythm was accelerated by his sympathy. Nervous system and adrenaline-stimulated stress response. In electrophysiology labs, drugs called isoproterenol can be used to simulate adrenaline and induce arrhythmia. In his case, life itself became his isoproterenol.

It really puts stress on the brain

These two patients received different diagnosis, but they had the same fear. There was something wrong with my heart. One had anxiety and false arrhythmia, and the other had a stress-induced increase in the false heart rate. In both cases, there is two-way mind- and mind communication that can disrupt patients and providers. Stress, cortisol, adrenergic surges, and the prefrontal cortex of the brain; decision makingshuts down. Note It’s getting narrower, Memory Fragments, and perceptions are distorted. Neuroscientists show how stress can hijack The brain’s decision-making pathway It leads to reactive thinking. Racing Hearts can feel like an imminent destiny even when there is no real danger. Chronic mental stress, especially worry and anti-cation, has been shown to continue physiologically activate the body for a long time after the stressor passes. This is called “patience.” Cognition“And it can increase blood pressure and reduce heart rate fluctuations. Prolonged exposure to stress can lead to an elevated cortisol status, which can feed back into the nervous system and further blur the boundaries between emotional and physical symptoms.

Wearable devices such as smartwatches and portable ECGs are double-edged swords, although they can help provide real-time data. Without context, rushing your heart rate can increase your fear. Data alone cannot replace the nuances of good history, nor can we distinguish between the normal heart rhythms raised by adrenaline and the true heart arrhythmia.

Restores rhythm through the nervous system

I recommend that patients lean on practices that regulate the body’s natural rhythms. meditationbreathing work, and yoga directly stimulate the parasympathetic nervous system Vagus nervehelps bring heart rate, breathing and thoughts to better integrity. I use it in SVT Missing To restore rhythm, it is a procedure that involves pouring cold water over your face. Even these physical techniques reflect the fact that when the nervous system feels safe, the heart often continues.

I’ll take your pulse

So I will continue to go back to this phrase: take your own pulse first. I’ll pause to take your pulse It reminds us to tune before we react. It inspires us to ask: am I really at risk or am I reacting to the past? trauma Was it caused by current events or inner stories? These questions, if asked early enough, can help you avoid personal suffering, relationship tensions, or reactions that could lead to misunderstandings, misdiagnosis, or invisible. Whether it’s a dismissed arrhythmias or stress misunderstood as heart disease, the lessons are the same. The heart often responds first. And while ECG can tell us part of the story, it’s rarely the whole thing. But all of that must be interpreted within the context of circumstances and history.