Cardiophobia (fear of heart attacks): symptoms, causes and treatment

An anxiety disorder related to the fear of suffering a serious cardiac disturbance.

If we say that someone is afraid of heart attacks, the truth is that most people will understand and understand, and even share, this fear. It is not for nothing that heart problems are one of the most frequent causes of death.

However, as a general rule, it is a fear that we have if we find ourselves in a situation in which we experience unusual and decontextualized discomfort or symptoms: as a general rule, we go about our daily lives normally and without any interruption to our daily lives.

But there are people for whom the fear of suffering a cardiac problem such as a heart attack (among other ailments) generates such a level of anxiety that they need to avoid any action that could trigger it, to the point that their lives may be severely limited by fear. These are people with cardiophobiaa psychological alteration of which we are going to speak next.

What is cardiophobia?

We give the name of cardiofobia to the phobia or panic to suffer some type of cardiac alteration, being the most frequent fear to suffer a heart attack..

Although this fear is something that can be perfectly understandable, the truth is that we are not dealing with a mere fear or worry in the face of confusing evidence: we are talking about a highly limiting phobia that generates great discomfort.

As a phobia, cardiophobia implies the existence of a reaction of fear, dread and extreme anxiety before the appearance of a certain stimulus or situation, This reaction is irrational (and the sufferers themselves usually consider it as such) or disproportionate in relation to the danger posed by that which triggers it.

Symptoms

The symptoms of cardiophobia are those of any similar phobia; the anxiety in the face of such stimulus usually generates an intense activation of our organism, provoking physiological symptomsThe symptoms of cardiophobia are those of any similar phobia; anxiety in the face of such a stimulus usually generates an intense activation of our organism, causing physiological symptoms that can lead to anxiety crises.

Among these symptoms we find dizziness, tachycardia, hyperventilation, sweating, fainting, tremors, or even the appearance of sensations or even the appearance of sensations that make us think of losing control of our own body, of losing reason or even of dying.

The existence of this dread of the feared stimulus causes the person to make great efforts to avoid situations in which the stimulus or elements related to it may appear, something which, depending on the stimulus, can cause great limitations in the patient's life.

In the case of cardiophobia, as we have said before, the phobia in question is that of suffering or being suffering from a heart disease, so that the person will tend to avoid all situations in which he/she may suffer from cardiopathy. will tend to avoid all those situations that make it easier to suffer a cardiac alteration, including everything that can make it easier to suffer a cardiac alteration, including everything that can make it easier to suffer a heart attack.including everything that can make our heart go at a different rhythm than usual.

Cardiophobia is also a type of phobia which can be associated can be associated with obsessive symptomatologywith frequent checks of one's own state in order to alleviate anxiety. A certain link can also be found with hypochondria, since it is not uncommon for these subjects to express the conviction that they are ill.

Curiously, the phobic reaction to the feared stimulus itself will increase the anxiety felt by people with cardiophobia, given that one of the physiological symptoms of anxiety is tachycardia. This generates a great suffering that will increase in crescendo, and makes it more likely that the subject may suffer an anxiety crisis.

Day-to-day effects

Suffering from cardiophobia can be very disabling, since anxiety is aroused by a type of stimulation that is difficult to control in our daily lives: the beating of our heart.

In this sense, the subject will tend to avoid anything that may generate a variation or alteration of their heart rate: it is common for them to stop doing any type of sport, to avoid having sexual relations or to avoid consuming food or drinks that may be exciting.

In severe cases, there may be a tendency to isolation and to abandon leisure activities. and to abandon leisure activities, or even work, to be able to cause a stress or anxiety that generate a cardiac alteration. Even in some very severe cases there may be a tendency to clinophilia or to remain bedridden and in a recumbent state.

In addition, in many cases the existence of cardiophobia can lead to obsessive behaviors, such as constantly checking the heart rate or Blood Pressure at the slightest effort (and even comparing the current heartbeat with previous states or with that of other people).

Likewise, and in a similar way to people with hypochondria, "doctor shopping" behaviors may appear, i.e., repeatedly visiting different medical centers and doctors, to go again and again to various medical centers and doctors in order to have their condition in order to have their condition evaluated. It is also possible (although less common) for the opposite behavior to occur: refusal to go to a hospital for fear of having a possible heart disease confirmed.

Causes of this phobia

As with other phobias, the exact causes of cardiophobia are not known, although it is considered that cardiophobia has a multi-causal and multifactorial origin (i.e. there is no single cause but rather a series of factors that must be added together). However, there are various hypotheses that attempt to explain why this and other phobias may occur.

In the first place, it should be considered that we are dealing with a discomfort or fear that, although irrational and exaggerated, has a function: that of avoiding harm. In this sense, it could be considered a phobia similar to those of injury, blood and injections. However, unlike the fear of spiders or heights, the fear of heart disease has a strong cognitive component, so that although its origin may stem from a partly inherited will to survive, it is generally considered that behind cardiophobia there is a sociocultural learning process.

One of the possible explanations is to be found in the learning or experience of a loved one or someone known to them having suffered a traumatic heart attack or cardiac event that caused death or great suffering. Regardless of whether it occurs in childhood or adulthood, knowledge of the symptoms or of the suffering or death of that person can be associated with the altered cardiac rhythm, something that will cause the person to learn and considering that rhythms different from the usual ones imply a dangerous and even fatal cardiopathy..

Another possible factor with great influence can be found in the learning of patterns and attitudes regarding health from parental models or the social environment, even without the need for direct experience. In fact, the knowledge that heart disease is one of the most common causes of death is a fact that can trigger anxiety and fear of suffering from it (something that is accentuated if there are also previous aversive experiences).

Given the aforementioned conditioning and learning, we can generate a cognitive scheme in which the tachycardia-cardiac problem relationship is kept present in a maximized way. In those situations in which an alteration of the cardiac rhythm appears, for example when doing sport, this scheme is activated in our psyche and a false alarm is set in motion, causing anxiety in order to lead us to an avoidance response.

In this case it is also necessary to take into account Reiss's expectancy modelaccording to which the phobia is maintained because exposure to the feared situation causes the subject's expectation of anxiety and danger from his own symptoms to overcome or confirm his fear. In this case, the anxiety involved in the subject generates an increase in symptoms such as tachycardia, which would cause the phobia to remain active.

Treatment

Although cardiophobia is a complex phobia, like the rest of phobias it can be treated in consultation. In this regard, once actual coronary pathology has been ruled out, it is possible to employ techniques such as exposure therapy.

The exposure technique is a basic but very useful technique in the treatment of phobias, which is mainly based on making the subject confront the feared situation and the anxiety it generates until it is reduced by habituation. In the present case, this would be a type of interoceptive exposure, i.e. making the subject be exposed to specific sensations.

In the case of cardiophobia, in which the anxious response can be a reason for the subject's fears to be confirmed, it is necessary to be very cautious when carrying it out. great caution in carrying it outIf it is not carried out correctly, it is possible to sensitize the patient even more.

It is necessary to jointly elaborate a graduation of stimuli to which the subject is going to be confronted little by little, in a continuous way until the anxiety decreases to a great extent. In this sense activities that the subject carries out and that generate cardiac activation will be and that generate cardiac activation, so that the subject can verify that even if the heart rate increases, this does not lead to a dangerous coronary event.

If there are obsessive checking behaviors, it may also be necessary to carry out exposure with response prevention, i.e., making the subject unable to check his heart rate or blood pressure and waiting for him to become accustomed to the anxiety.

It may also be necessary to work at the cognitive level.The patient's health beliefs, thoughts about what is happening, the meaning he/she gives to the cardiac event, the work with possible traumatic experiences or dysfunctional schemas and the expectations of danger and risk he/she may be having, should be worked on with the patient, probably even earlier than behaviorally. Stress management may also be something to address.

Also relevant may be the use of relaxation techniques. If necessary, it may be appropriate to use drugs such as benzodiazepines to reduce the level of anxiety and allow a more cognitive and behavioral work.

Bibliographical references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Santos, J.L. ; García, L.I. ; Calderón, M.A. Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Román, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Psicología Clínica. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.