Can patients with anxiety disorders have abnormal electrocardiograms (ECGs)?

Patients with anxiety disorders may exhibit transient abnormalities on electrocardiogram (ECG), but most cases do not involve organic heart disease. Sympathetic nervous system activation during anxiety can lead to increased heart rate and enhanced myocardial contractility, potentially causing sinus tachycardia, ST-T segment changes, or prominent U waves. These changes are usually associated with emotional fluctuations rather than structural cardiac damage. However, concomitant conditions such as coronary artery disease or myocardial ischemia must be ruled out, as anxiety symptoms may mask typical manifestations of heart disease. ECG findings should be interpreted in conjunction with clinical symptoms and other diagnostic tests.

It is recommended to document specific details of palpitation episodes, such as duration and triggers, and to cooperate with physicians in performing Holter monitoring or echocardiography. Anxiety can be relieved through daily practices such as deep breathing and progressive muscle relaxation, and patients should avoid stimulants like coffee and strong tea. If ECG abnormalities persist or are accompanied by chest pain or syncope, prompt consultation with a cardiologist is advised, along with further investigations such as coronary CT angiography or biochemical blood tests. Maintaining regular sleep patterns and engaging in moderate aerobic exercise can help improve autonomic nervous system function. Psychotherapies, such as cognitive behavioral therapy, can also help alleviate anxiety symptoms and associated physical discomfort.