Family, Internal Medicine, General Medical Questions/Fear of Variant Angina

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Dear Dr. Before I was getting help from Dr. David Riachardson (cardiologist), he was caring & removed my fear & anxiety many times.He is unavailable now.  I hope u can also help me. I am male 46 years old with severe health anxiety since 12 years. Since childhood I have been a worrier, very sensitive & fearful. I struggle with unemployment after marriage & HIV fear for 2 years. Since last 12 years I have obsessing about heart related fear, heart attack, heart disease, arrhythmia, angina etc. Time to time I was being occupied & living with fear that, something happened to my heart. I did 3 Echocardiography, 3 stress treadmill test, 4 24 hr holter monitor test, several ekgs. I have Mitral valve Prolapse with Trivial MR, which was diagnosed 5 years back. I am been googling that, anxiety chest pain/chest tightness or palpitation are harmless to be relaxed from anxiety & mvp & came across many unwanted  heart related symtoms, which made me very obsessed & fearful. I was trying to get assurance on one symptoms, another symptoms I will pickup from the internet, like this cycle continuing, While browsing the anxiety I came across a word Variant Angina(which is without blockage, your arteries will go to temporary spasm/stop blood) I somehow manage to overcome this fear after lot of efforts but, one setback came, that, the way to diagnose is to hyperventilate the patient & do EKg. Since then i got more feared. Now i am fearing if i hyperventilate i will get coronary artery spasm & will dies. I know that it is wrong, but i started obsessing about the word hyperventilation. If it is like that, all anxious people who hyperventilate will get coronary artery spasm & die. I am trap in to fear. plz help me to come out of the vicious cycle of fear. I will be grateful to you all my life. I have two kids & wife. I don't have any help from anyone. I was coping with the anxiety symtoms (chest pain/palpitation/chest tightness/dizziness/lightheadedness/jelly leg etc), by reading Dr. Claire weekes book, that, anxiety will not kill you. Now I came to where I was in the beginning. I started to worry about all anxiety symptoms & fearing that it will cause coronary artery spasm/heart attack. I know anxiety causes hyperventilation, i am misinterpreting all this symptoms. I am coping with the fear of coronary artery spasm that, it is similar to heart attack & chest pain should be severe for more than 5mintues & mostly are young females, but whenever I think of word hyperventilation or whenever I feel anxious, suddenly it comes to my mind. plz help me to come out of this fear. God bless you."

Answer
variant angina is very rare and not likely to occur..... if you had the stress tests, from my standpoint, there are no worries......    That is a hard disease to prove, primarily because it is very rare, so not a lot of people to study and some of the special testing is involved...... I guess  you need to discuss this again with your cardiologist, but anxiety disorder aside (not easy), there is no big reason to worry about it....

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Robert Borucki

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