Results from heart monitor-please help explain

[adviceseeker777]

Ok, as I posted before I have been having intense episodes of anxiety and heart racing.  Had been to ER a number of times, had a bunch of EKGs done (normal) and saw a cardiologist for another EKG, sonogram, and stress test. (i'm 39 years old and in ok shape- quit smoking months ago, not really overweight).  Cardiologist had said my heart was normal and all looked good.
After another scary episode of racing heart, just had  24 hour heart monitor. The cardiologist said that my heart is completely normal and that yes, it does race, and that 2x during the day it went up to 150some bpm.  So I go anywhere from 50bpm to 150bpm.  He says it's fine. I'm freaking out.  I asked if I could possibly have SVTs or any other kind of dangerous arrhythmia and he said no, this was all coming from my anxiety.  I asked him about taking the beta blockers my shrink recommended to keep my heart slowing down and he said he didn't think it would work because the problem isn't my heart! WHAT????  So what am i supposed to do?  This really has not given me much relief and I felt as if he didn't give me enough information.  He wanted to speak to my shrink instead.  Great.  My shrink just called me and said as soon as he got the reports he would go over everything with me.  But I'm scared.  And don't know how to handle this racing heart which has sent me to the ER a number of times thinking I"m about to die.
HOw could it be normal for a heart to go from 50bpm to 150bpm when I wasn't doing exercise????  And this happens DAILY?  Do you think he's giving a fair assessment or is there a more serious problem here and he's just dismissing me as neurotic (which, by the way, i'm fully aware I am or I wouldn't already be seeing a shrink).  My shrink said I'm having severe anxiety and that I'm experiencing sinus tachycardia.  
any ideas?  Does this all seem normal? Should i have more tests? A second opinion?  I'm already on benzos for the anxiety and this does NOT always slow heart down.  I'm terrified.

[Michael J. McWilliams, M.D.]

I haven't seen your studies but if they show sinus tachycardia (normal tachycardia), the problem is not your heart.  It is the signals being sent to your heart.  It sounds like anxiety is the root of your problem.  There is little harm in giving a beta blocker to help slow down the heart rate.  It does help some people.  Beta blockers give great relief to people with public speaking phobias.  If your doctor is willing to try a beta blocker, it might help.

I don't think  your cardiologist is saying you can't have one.  The message they are probably sending is that his is not a primary heart related issue and that they prefer your other doctors manage it.  As an EP, I am frequently referred situations like yours.  Once I know it is not a primary heart issue, I usually release patients back to their primary doctors as well.

Talk to your psychiatrist and see what they think.  They have more experience treating problems with anxiety.  Part of feeling better is probably convincing yourself that there is not a problem with your heart.  Until you believe that, you are a set up for more panic attacks.

I hope this helps.

[adviceseeker777]

Thank you.  So you can tell from these EKG's and heart monitors whether or not the racing is normal?  I have been under a psychiatrist's care for years now and the 'panic disorder' was under control for awhile and then came back with a vengeance this year.  It is a challenge to find meds that will actually keep the symptoms under control.  

BUT, if my heart keeps racing, what am I supposed to do to stop it?  I've had it go up to 200 in past and scared the hell out of me. When is it dangerous?  And when is it important for me to go to the ER?? And when am I in danger of having a heart attack?
because it feels like I'm on the verge...
thanks much,
k