Hypervigilance means having increased awareness and sensitivity to certain physical symptoms or situations. It’s natural after a SCAD to be focused on every pain and twinge, especially related to your own SCAD experience. It is possible to learn strategies to manage this anxiety.
There are several reasons you may experience chest pains and discomfort after having a SCAD:
Firstly, Healing (often spasm-like) pains have been reported by 60-90% of SCAD patients in different research studies, particularly by people who have stents.
It can be helpful to read up on Chest pain after SCAD, as being informed can reduce the chance of becoming hypervigilant.
Secondly, anxiety can become a feature of post-SCAD life for many, with every slight change in the body causing a ‘what was that’, ‘is this the start of another SCAD?’ With your mind on high alert, looking out for any small changes in the body, it is no wonder we find them.
Many patients also experience ectopic heartbeats during their SCAD recovery. Dr Adlam talks about this from 41 minutes in this video. Knowledge = Power.
The role of adrenaline
Unfortunately, when the brain notices a concern, internal or external threat, the body responds by sending a very helpful hormone called adrenaline. Adrenaline is fantastic if we are being chased by a tiger (a real threat), running a marathon (sporting activity) or studying for an exam (stressful situation) but less helpful if you are worrying about a discomfort in your chest.
Adrenaline speeds up your metabolism ready for fight or flight or sometimes freeze. Unfortunately, many of the symptoms of adrenaline are very similar to heart attack symptoms:
For example: adrenaline may cause chest pains as muscles contract to protect the heart from a physical threat, heart races to send oxygen round the body so we can run from a physical threat, blood moves quickly to legs and arms to fight or run causing sweating, dizziness and sometimes nausea.
If we start to worry about these adrenaline symptoms, we can start a cycle of anxiety: worry about small discomfort in heart or become aware of sweating, brain will register a threat, the body will produce adrenaline and heart becomes more uncomfortable, races more and sweating increases, worry more, more adrenaline….
Anxiety and panic attacks
Panic attacks can very easily mimic heart attacks. Some re-admissions to hospital after SCAD for chest pain that turn out to be a false alarm are caused by anxiety.
If anxiety is becoming a problem for you, please speak to your GP. Medication or referral to a Cognitive Behavioural Therapist can be helpful.
Remembering that worrying will only increase uncomfortable physical symptoms of adrenaline. So try to focus your attention on other things… speaking to other people, jigsaws, craft activities, stroking a pet, going for a walk. Watching funny TV is great - laughter really can be the best medicine.
Resting your brain
Learning how to ‘rest’ the brain is key to mental recovery.
- Click here for an example of a relaxation video.
- Different breathing techniques: breathing mindfully, 478, rectanglle breathing (see FAQ)
- Mindfulness
- Prioritising sleep and diet.
The worry tree can be a helpful way of categorising your worries into things you can do something about (problem) and things that are out of your control (what ifs). You can find a downloadable worry tree and guidance on how to use it here.
Getting help
It is important to seek medical advice if your chest pains are persistent and relaxation or distraction techniques that normally help are not useful. Even if you go to hospital and it is a false alarm, this is an important learning experience and can help you to determine what is another SCAD and what symptoms are caused by something else (anxiety, healing heart pains, flu symptoms, tiredness etc).
For more please see this information about anxiety from Northumberland NHS.
Resources
Hypervigilance means having increased awareness and sensitivity to certain physical symptoms or situations. It’s natural after a SCAD to be focused on every pain and twinge, especially related to your own SCAD experience. It is possible to learn strategies to manage this anxiety.
There are several reasons you may experience chest pains and discomfort after having a SCAD:
Firstly, Healing (often spasm-like) pains have been reported by 60-90% of SCAD patients in different research studies, particularly by people who have stents.
It can be helpful to read up on chest pains after SCAD, as being informed can reduce the chance of becoming hypervigilant.
Secondly, anxiety can become a feature of post-SCAD life for many, with every slight change in the body causing a ‘what was that’, ‘is this the start of another SCAD?’ With your mind on high alert, looking out for any small changes in the body, it is no wonder we find them.
Panic attacks can very easily mimic heart attacks. Some re-admissions to hospital after SCAD for chest pain that turn out to be a false alarm are caused by anxiety.
If anxiety is becoming a problem for you, please speak to your GP. Medication or referral to a Cognitive Behavioural Therapist can be helpful.
For more please see this information about anxiety from Northumberland NHS.
This breathing exercise can quickly reduce anxiety symptoms.
- First, let your lips part. Make a whooshing sound, exhaling completely through your mouth.
- Next, close your lips, inhaling silently through your nose as you count to 4 in your head.
- Then, for 7 counts, hold your breath.
- Make another whooshing exhale from your mouth for 8 counts.
When you inhale again, you start a new cycle of breath. Try to practice this pattern for four full breaths. You might feel a little lightheaded the first time you try it. If you begin to feel uncomfortable during your practice, allow yourself to take a break and consider drinking water. Initially you are just counting at a pace that feels comfortable, you may build up to seconds as you continue to practice.
There are some additional resources below with a few ideas to try.
The worry tree can be a helpful way of categorising your worries into things you can do something about (problem) and things that are out of your control (what ifs).
You can find a downloadable worry tree and guidance on how to use it here.
The idea is to notice the worry and ask yourself what you are worrying about. Is it a hypothetical situation or a current problem. Can you do anything about it? If it’s hypothetical, let the worry go, then change what you’re focusing your attention on; if it’s a current problem, make an action plan, then change what you’re focusing your attention on.