Cardiophobia (fear of heart attack)-symptoms, causes, and treatment
If we say that someone is afraid of heart attacks, the truth is that most people will understand and even share that fear. Not surprisingly, heart problems are one of the most common causes of death.
However, as a general rule, this is a fear we have if we are faced with a situation where we find uncommon and out-of-context discomfort or symptoms: as a rule we live our day-to-day life normally and without any interruption in our daily lives.
But there are people for whom the fear of suffering a heart problem such as a heart attack (among other ailments) generates such a level of anxiety that they need to avoid any action that will generate an activation, to the point that they may see their lives severely limited by fear. These are people with cardiophobia , a psychological disorder that we are going to talk about next.
What is Cardiophobia?
We give the name of cardiophobia to the phobia or panic to suffer some kind of heart disorder, being the most frequent fear of suffering a heart attack .
While this fear is something that may be perfectly understandable to us, the truth is that we are not facing mere fear or concern in the face of confusing evidence: we are talking about a highly limiting phobia that generates great discomfort.
As a phobia that it is, cardiophobia implies the existence of a reaction of fear, dread and extreme anxiety before the appearance of a certain stimulus or situation, being this reaction irrational (and the very people who suffer it usually consider it as such) or disproportionate in relation to the danger that the stimulus or situation implies.
The symptoms of cardiophobia are those of any similar phobia; anxiety in the face of this stimulus usually generates an intense activation of our organism , causing physiological symptoms that can lead to the appearance of anxiety crises.
Among these symptoms we find dizziness, tachycardia, hyperventilation, sweating, fainting, trembling or even the appearance of sensations that make one think of losing control of one’s body, losing one’s mind or even dying.
The existence of this fear of the feared stimulus makes the person make great efforts to avoid those situations in which it may appear or the stimulus or elements linked to it, something that depending on the stimulus can cause a great limitation in the life of the patient.
In the case of cardiophobia, as we have said before, the phobia in question is that of suffering or being suffering from a cardiopathy, so that we will tend to avoid all those situations that facilitate suffering a cardiac alteration , including everything that may cause our heart to go at a different rhythm than usual.
Cardiophobia is also a type of phobia that can be associated with obsessive symptoms , with frequent checks of one’s state in order to alleviate anxiety. A certain link with hypochondria can also be found, as it is not uncommon for these subjects to express the conviction that they are ill.
Interestingly, the very phobic reaction to the feared stimulus will increase the anxiety felt by people with cardiophobia, since one of the physiological symptoms of anxiety is tachycardia. This generates a great suffering that will increase, making it more likely that the subject will suffer an anxiety crisis.
Cardiophobia can be very disabling, since anxiety is awakened by a type of stimulation that we can hardly control in our daily lives: the beat of our heart .
In this sense, the subject will tend to avoid everything that could generate a variation or alteration in 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 could be exciting.
In severe cases, there may be a tendency to isolate oneself and to abandon leisure activities, or even work, as this may cause stress or anxiety that may lead to a cardiac disorder. Even on some very severe occasions there may be a tendency to clinophilia or to remain in bed and in a recumbent state.
In addition, in many cases the existence of cardiophobia can lead to obsessive behaviour, 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 similarly to people with hypochondria, “doctor shopping” behaviour can occur, i.e. going time and time again to various medical centres and doctors to have their condition assessed. It is also possible (although less usual) that the opposite behaviour takes place: refusing to go near a hospital for fear of being confirmed as having a possible heart disease.
Causes of this phobia
As with other phobias, the exact causes of cardiophobia are not known, although cardiophobia is considered to have a multicausal and multifactorial origin (i.e. there is no single cause but a series of factors must be added together). However, there are several hypotheses that attempt to explain why this and other phobias can occur.
First of all, we must consider that we are facing an uneasiness or a fear that, although irrational and exaggerated, has a function: that of avoiding damage. In this sense, it could be considered a phobia similar to those of damage, blood and injections. However, unlike fear of spiders or of heights, fear of heart disease has a strong cognitive component, so that although its origin may be based on a desire to survive, which is partly inherited, it is generally considered that behind heart disease there is a socio-cultural learning process .
One of the possible explanations can be found in learning or experiencing that a loved one or someone you know has suffered a traumatic heart attack or heart event that has caused death or great suffering. Regardless of whether it occurs in childhood or adulthood, the knowledge of the symptoms or the suffering or death of this person may be associated with the altered heart rhythm, something that will cause the person to end up learning and considering that different rhythms from the usual one imply a dangerous and even fatal heart disease .
Another possible factor with great influence can be found in the learning of patterns and attitudes towards health by parental models or the social environment, even without having had 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).
In view of the aforementioned conditioning and learning, we can generate a cognitive scheme in which the tachycardia-cardiac relationship is maintained in a maximized way. In those situations in which an alteration of the heart rhythm appears, for example when doing sport, this scheme is activated in our psyche and a false alarm is set off which causes us anxiety in order to lead us to the avoidance response.
In this case, it is also necessary to take into account the model of Reiss’s expectation , according to which the phobia is maintained because the fact of being exposed to the feared situation makes the subject’s expectation of anxiety and danger from his own symptoms overcome or confirm his fear. In this case, the anxiety that the subject has generates an increase in symptoms such as tachycardia, which would make the phobia remain active.
Although cardiophobia is a complex phobia, like all other phobias it can be treated in consultation. In this sense, once the real 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 face the feared situation and the anxiety it generates until it ends up being reduced by habituation. In this case, it would be a type of interoceptive exposure, that is, making the subject expose him/herself to specific sensations.
In the case of cardiophobia, where the anxious response can be a reason for the subject to see his fears confirmed, it is necessary to take great care in carrying it out : if it is not carried out correctly it is possible to make the patient even more sensitive.
It is necessary to elaborate together a graduation of stimuli that the subject will face 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 introduced, so that the subject can check that even if the heart rate increases, this does not lead to a dangerous coronary event.
If there are obsessive testing behaviors, it may also be necessary to perform response prevention exposure, i.e. making the subject unable to test his heart rate or blood pressure and having to wait to become accustomed to the anxiety.
It may also be necessary to work at a cognitive level , probably even before in a behavioural way, as the beliefs about health, the thoughts about what is happening, the significance given to the cardiac event, the work with possible traumatic experiences or dysfunctional patterns and the expectations of danger and risk that the patient may be having will have to be worked with. Stress management can also be addressed.
The use of relaxation techniques may also be relevant . If necessary, it may be appropriate to use drugs such as benzodiazepines to reduce the level of anxiety and allow for more cognitive and behavioural work.
- You may be interested in: “Intervention in phobias: the technique of exposure”
- 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). Clinical Psychology. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.